Irradiated rib cartilage graft for reconstruction of the tympanic membrane: Preliminary results

Objective: To evaluate the advantages, disadvantages, safety, and results i n reconstruction of the tympanic membrane using irradiated rib cartilage. Study Design: Retrospective chart review. Setting: A tertiary referral center. Patients: All patients who had greater than or equal to 6 months follow-up who underwent tympanoplasty or tympanomastoidectomy using irradiated rib ca rtilage graft at our institution from January 1, 1993 to December 31, 1996. Intervention: Tympanoplasty or tympanomastoidectomy using homologous irradi ated rib cartilage as graft material. Main Outcome Measures: Postoperative speech reception thresholds, speech di scrimination scores, and air-bone gap were compared with preoperative level s. Complications directly related to irradiated rib cartilage tympanoplasty were sought. Results: Speech reception threshold did not significantly change. Speech di scrimination scores were stable or improved in all patients. Postoperative air-bone gap was less than or equal to 10 dB in 43.2% of patients and less than or equal to 20 dB in 70.3% of patients. There was a 16% complication r ate regarding tympanoplasty in general. No complications unique to irradiat ed rib cartilage occurred. Conclusion: Irradiated rib cartilage is an alternative tympanoplasty materi al that may save operating time, spares patients an added incision, provide s results similar to other grafting material, and is safe.