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Cartilage "Shield" Grafts in Revision Tympanoplasty

Objective: To report our experience with cartilage "shield" grafts in revision tympanoplasty. Study Design: Retrospective chart review at a tertiary referral center. Patients underwent revision tympanoplasties by replacing the entire tympanic membrane with concha cymba cartilage shaped as a shield. Main Outcome Measures: Successful graft take was defined as having no perforation, graft retraction, or lateralization. Hearing results were analyzed by comparing the preoperative and postoperative pure-tone average air-bone gap and speech discrimination scores. Results: Forty-three patients underwent 46 procedures. Graft take was successful in 43 procedures (93.5%). There was no graft lateralization or displacement into the middle ear. An overall postoperative air-bone gap of 25 dB or less was achieved in 22 of the 39 patients (56.4%), and speech discrimination scores remained unchanged. Conclusion: Cartilage shield tympanoplasty is a reliable procedure for revision tympanoplasty patients, with excellent graft take and significant improvement of hearing.