Doğan ÇAKAN

Kullanılan Farklı Greft Tiplerinin Revizyon Timpanoplasti Sonuçlarına Etkisi

Amaç: Bu çalışmadaki amaç kliniğimizde uygulanan revizyon timpanoplasti operasyonları inceleyerek elde edilen sonuçları literatür eşliğinde tartışmaktır. Gereç ve Yöntemler: 1 Ocak 2015- 31 Aralık 2020 tarihleri arasında kliniğimizde revizyon timpanoplasti operasyonu uygulanan; primer cerrahisi kliniğimizde uygulanmış, primer cerrahide postaurikuler insizyon ve underlay teknik ile greft materyali olarak temporal kas fasyası kullanılmış olan, ikinci cerrahi öncesi en az 3 ay akıntısız takip edilmiş olan 38 hasta çalışmaya dahil edildi. Sekonder cerrahide kullanılan greft materyalleri belirlendi ve postoperatif sonuçlar 6. Ay işitme sonuçları ile beraber istatistiksel olarak değerlendirildi. Bulgular: Otuz iki hastanın yaş ortalaması 42.90±14.50(min:15,max:60) olarak saptandı. Sekonder cerrahi nedeni olarak kulak zarı perforasyonu(%84,2), greft lateralizasyonu(%5,2), ossiküler fiksasyon(%10,5), işitme rekonstrüksiyonunda başarısızlık(%10,5), timpan zar üzerinde retraksiyon cebi(%26,3) ve koleastatoma(%15,7) tespit edildi. Sekonder cerrahi olarak 16(%42,1) hastada tip 1 timpanoplasti, 8(%21) hastada ossiküloplasti, 10(%26,3) hastada mastoidektomi uygulandı. Greft materyali olarak hastaların 12’sinde(%31,5) temporal kas fasyası, 24’ünde(%63,1) inceltilmiş tragal kartilaj, 2’sinde(%5,2) tragal kartilaja ait perikondrium kullanıldı. Greft türlerine göre elde edilen 6. Ay işitme kazançları incelendiğinde, temporal fasya kullanılanlarda ortalama 21,83±6.46 dB kazanç, tragal kartilaj kullanılanlarda ortalama 21,25±6.94 dB kazanç, perikondrium kullanılanlarda ortalama 7.50±3.50 dB kazanç elde edildi ve istatistiksel olarak anlamlı bir fark tespit edilmedi(p=0,061; p

Anahtar Kelimeler:

Greftler, İşitme, Otitis Media, Revizyon cerrahi, Timpanoplasti

The Effect Of Graft Types Used On Revision Tympanoplasty

Objective: The aim of this study is to examine the revision tympanoplasties performed in our clinic and to discuss the results in the light of literature. Material ve Methods: The 38 patients who underwent revision tympanoplasty in our clinic between January 1, 2015 and December 31,2020 ,whose primary surgery was performed in our clinic, with using temporal muscle fascia as the graft, the postauricular incision and underlay technique as the surgery method, and who were followed up without otorrhea for at least 3 months before the second surgery, were included in this study. Results: The mean age of 32 patients was 42.90±14.50(min: 15, max: 60) years. Perforation of the tympanic membrane(84.2%), graft lateralization(5.2%), ossicular fixation (10.5%), failure in hearing reconstruction(10.5%), retraction pocket on the tympanic membrane(26%) and choleastatoma(15.7%) were detected as secondary surgical causes. As secondary surgery, type 1 tympanoplasty in 16(42.1%) patients, ossiculoplasty in 8(21%) patients, and mastoidectomy was performed in 10(26.3%) patients. Temporal muscle fascia was used in 12(31.5%) patients, tragal cartilage in 24(63.1%) patients, and perichondrium of tragal cartilage in 2(5.2%) patients as graft material. The hearing gain means were 21.83±6.46 dB in those using temporal fascia, 21.25±6.94 dB in those using cartilage and 7.50±3.50 dB in those using perichondrium in 6th month examination. No statistically significant difference found in hearing gains (p=0,061, p

Keywords:

Grafts; Hearing; Otitis Media; Revision Surgery; Tympanoplasty,

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