Type III cartilage “shield” tympanoplasty: An effective procedure for hearing improvement

OBJECTIVE: To report the hearing results following type III cartilage "shield" tympanoplasty. STUDY DESIGN: Retrospective chart review at a tertiary referral center. METHODS: Conchal cartilage, shaped as a shield, was used to replace the entire tympanic membrane and reconstruct the ossicular chain in patients with an absent incus and diminished space between the stapes superstructure and malleolar manubrium. RESULTS: Between January 1998 and June 2005, 52 patients were treated. The mean age was 32.4 years (range, 7 to 72 years). The mean follow-up was 24 months (range, 12 to 36 months). Graft take was successful in all patients. The average hearing improvement was 11.22 dB (P<0.0001). An air-bone gap of 25 dB or less was achieved in 41 (78.8%) patients. Speech discrimination scores remained unchanged. No complications were identified. CONCLUSION: Type III cartilage "shield" tympanoplasty is an effective technique for hearing improvement in selected patients with chronic otitis media. The results of this procedure are similar to those obtained with partial ossicular replacement prosthesis.