Eur Arch Otorhinolaryngol. 2013 Feb 26. [Epub ahead of print]

Cartilage tympanoplasty: a reliable technique for smokers.

Kyrodimos E, Stamatiou GA, Margaritis E, Kikidis D, Sismanis A.

Source

Department of Otolaryngology, Head and Neck Surgery, Hippokration General Hospital, National University of Athens, 114 Queen Sofia Avenue, 11527, Athens, Greece.

Abstract

Κυροδήμος Ευθύμιος, Ωτορινολαρυγγολόγος, Λέκτορας της Ιατρικής Σχολής του Πανεπιστημίου Αθηνών

The aim of this study was to report our experience with cartilage tympanoplasty (CT) in smokers and compare it with that of non-smokers using a retrospective chart review at a tertiary referral center. Between September 2008 and September 2010, cartilage tympanoplasty was performed in 52 patients. Among them, 27 were active smokers and 25 former or non-smokers. The entire tympanic membrane was replaced with conchal cartilage, shaped either as a shield for cases with intact canal wall mastoidectomies, or crashed for cases with canal wall down procedures.

The mean post-operative follow-up was 12 months (range 6-18 months). A complete pre- and post-operative audiologic evaluation was obtained in all patients. Graft take was successful in all patients. The overall average pre-operative and post-operative pure tone average air-bone gaps (PTA-ABG) was 52.2 dB ± 17.7 dB and 35.4 dB ± 17.9 dB, respectively, with an overall improvement of 16.8 dB (p < 0.001).

A post-operative PTA-ABG of 25 dB or less was achieved in 39 (75 %) patients (p < 0.001). In smokers, the hearing improvement was 17.6 dB (p < 0.001) with a PTA-ABG of 25 dB or less in 19 (70 %). In non-smokers, the average hearing improvement was 16.8 dB (p < 0.0005) with a post-operative PTA-ABG of 25 dB or less in 19 (76 %), (p < 0.001).

The results showed that the CT technique is a very effective procedure for smokers. Excellent graft take and satisfactory hearing results can be accomplished regardless of smoking habits.