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  • Title: Combined intact bridge mastoidectomy with ring graft tympanoplasty.
    Author: Amin Albirmawy O, Aly Erfan FH.
    Journal: J Otolaryngol Head Neck Surg; 2011 Apr; 40(2):122-30. PubMed ID: 21453647.
    Abstract:
    OBJECTIVE: To assess the anatomic and audiologic results of tympanoplasty types I, II, and III using a ring graft in conjunction with intact bridge mastoidectomy for management of chronic otitis media, mucosal type. DESIGN: Retrospective clinical study. SETTING: Department of Otolaryngology-Head and Neck Surgery, Tanta University Hospital, Egypt. METHODS: The records of 97 patients with chronic otitis media (mucosal type) who underwent intact bridge mastoidectomy and ring graft tympanoplasty were evaluated. Of those, 54, 26, and 17 ears were included in tympanoplasty type I, II, and III groups, respectively. MAIN OUTCOME MEASURES: The postoperative graft success rate, including tympanic membrane healing without perforation, retraction, lateralization, or blunting and hearing acuity, including pure-tone average air-bone gap (PTA-ABG) and speech reception threshold (SRT), were evaluated. RESULTS: The graft success rate was achieved in 96%, 96%, and 94% of tympanoplasty type I, II, and III groups, respectively, with a highly significant difference within each group. However, the graft success rate did not achieve a significant difference between the surgical groups. PTA-ABG and SRT levels improved significantly with surgery in all groups. However, comparison of audiometric results between the study groups did not reveal any statistically significant difference. CONCLUSIONS: Performing tympanoplasty type I, II, and III using a ring graft for management of mucosal type chronic otitis media in conjunction with intact bridge mastoidectomy yielded good anatomic and audiologic results. This combined technique allowed good surgical exposure, adequate aeration of the middle ear space, and good healing of the tympanic membrane over a transparent central perichondrium.
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