TY - JOUR ID - 13538 TI - Tri-layer Tympanoplasty as a New Technique in High-risk Tympanic Membrane Perforations JO - Iranian Journal of Otorhinolaryngology JA - IJORL LA - en SN - 2251-7251 AU - Solmaz, Fevzi AU - Akduman, Davut AU - Haksever, Mehmet AD - Department of Otorhinolaryngology, Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital,16800 Yıldırım, Bursa, Turkey. AD - Department of Otorhinolaryngology, Duzce University Hospital, Duzce, Turkey. Y1 - 2019 PY - 2019 VL - 31 IS - 5 SP - 259 EP - 265 KW - Cartilage tympanoplasty KW - Chronic otitis media KW - Tri-layer tympanoplasty KW - Temporal fascia KW - Tragal cartilage DO - 10.22038/ijorl.2019.34408.2140 N2 - Introduction: The eradication of the middle ear disease is mentioned as the fundamental principle of tympanoplasty. The presence of some factors related to patient or disease itself forces the physician to classify the chronic ear disease as high-risk perforations. The aim of this study was to present a tri-layer tympanoplasty technique and its otological and audiological outcomes in the ears with high-risk perforations.   Materials and Methods: This retrospective study was carried out on a total of 46 eligible ears that had chronic otitis media with high-risk perforations. Preoperatively, 17, 15, and 14 ears were reported with Sade classification grade 4 pars tensa retraction (Group 1), total or near-total tympanic membrane perforation (Group 2), and a history of ear surgery (Group 3), respectively. All the cases had tympanoplasty using the tri-layer technique at a tertiary center during 2008 and 2014. A review of the patients’ chart showed that 46 patients underwent tri-layer tympanoplasty. Regarding the audiological outcomes, the comparison of pre- and post-operative results revealed mean air conduction level and mean air-bone gap (ABG) of 4 different frequencies in dB according to a new standardized format for reporting hearing outcome in clinical trials.   Results: The mean value of the follow-up period was reported as 29.22±3.23 months. Graft take rate was 93.4 % in all the cases, as well as 94.1%, 100%, and 85.7% in Group 1, Group 2, and Group 3, respectively. The mean values of ABG were improved from 35.17±6.64 to 23.52±10.4, 30.46±5.89 to 17.20±8.04, and 29.14±8.37 to 16.14±5.02 dB in Group 1, Group 2, and Group 3, respectively (P<0.05).   Conclusion: Tri-layer tympanoplasty is a reliable procedure in the surgical treatment of the chronic otitis media with high-risk re-perforations. UR - https://ijorl.mums.ac.ir/article_13538.html L1 - https://ijorl.mums.ac.ir/article_13538_1b8b9df5c457637c297c3264062b4167.pdf ER -