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ORIGINAL RESEARCH

The Effect of Eustachian Tube Dimensions on the Success Rate of Cartilage Type 1 Tympanoplasty
Östaki Tüpü Boyutlarının Kartilaj Tip 1 Timpanoplasti Ameliyatının Başarı Oranına Etkileri
Received Date : 03 Jul 2023
Accepted Date : 26 Oct 2023
Available Online : 06 Nov 2023
Doi: 10.24179/kbbbbc.2023-98692 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2024;32(1):16-22
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: To clarify the influence of eustachian tube (ET) anatomical measurements on the success rate of Type 1 cartilage tympanoplasty. Material and Methods: The medical records of 99 patients, who underwent cartilage Type 1 tympanoplasty were reviewed retrospectively. The length of ET (ETl), tubotympanic angle (TTa), ETReid horizontal plane angle (ETa), and ET pretympanic diameter (ETd) were measured on temporal bone computed tomography using the multiplanar reconstruction technique. Two groups were created based on the anatomical success of the procedure. Group 1 consisted of ears with successful anatomic outcomes and Group 2 consisted of ears without successful anatomic outcomes a year postoperatively. The ET anatomical measurements of Groups 1 and 2 were compared. Results: A total of 108 ears (90 unilateral and 9 bilateral ears of 99 patients) were included in our study. The differences between the ETl, TTa, ETa, and ETd of Groups 1 and 2 were statistically insignificant. Conclusion: Our study showed that ETl, TTa, ETa and ETd do not have a significant role in the anatomic outcome of Type 1 cartilage tympanoplasty. Using cartilage grafts in Type 1 tympanoplasty might be preferred to rule out the anatomical disadvantages regarding the ET. Studies with greater sample sizes are required to assess both the anatomy and function of the ET in the success rate of Type 1 tympanoplasty with various graft types.
ÖZET
Amaç: Bu çalışmanın amacı, östaki tüpü [eustachian tube (ET)] anatomik ölçümlerinin kartilaj Tip 1 timpanoplasti ameliyatının başarı oranı üzerindeki etkilerini açıklamaktır. Gereç ve Yöntemler: Kartilaj Tip 1 timpanoplasti ameliyatı uygulanan 99 hastanın tıbbi kayıtları retrospektif olarak incelendi. Temporal kemik bilgisayarlı tomografisinde multiplanar rekonstrüksiyon tekniği kullanılarak ET uzunluğu [length of ET (ETl)], tubotimpanik açı [tubotympanic angle (TTa)], ET-Reid yatay düzlem açısı [ET-Reid horizontal plane angle (ETa)] ve ET pretimpanik çapı [ET pretympanic diameter (ETd)] ölçüldü. İşlemin anatomik başarısına göre 2 grup oluşturuldu. Ameliyattan 1 yıl sonra anatomik sonuçları başarılı olan kulaklar Grup 1’e, başarısız olan kulaklar Grup 2’ye dâhil edildi. Grup 1 ve 2’nin ET anatomik ölçümleri karşılaştırıldı. Bulgular: Çalışmamıza toplam 108 kulak (90 hastanın 90 unilateral ve 9 bilateral kulağı) dâhil edildi. Grup 1 ve 2’nin ETl, TTa, ETa ve ETd değerleri arasında istatistiksel olarak anlamlı fark bulunmadı. Sonuç: Çalışmamız ETl, TTa, ETa ve ETd’nin kartilaj Tip 1 timpanoplastinin anatomik sonucunda anlamlı bir etkisi olmadığını göstermiştir. ET ile ilgili anatomik dezavantajları ortadan kaldırmak için Tip 1 timpanoplastide kartilaj greftlerin kullanılması tercih edilebilir. Tip 1 timpanoplastide ET’nin anatomisini ve işlevini değerlendirmek için çeşitli greft tipleri kullanılarak yapılmış daha büyük örneklemli çalışmalara ihtiyaç vardır.
KAYNAKLAR
  1. Wullstein HL. Functional operations in the middle ear with split-thickness skin graft. Arch Otorhinolaryngol. 1952;161:422-35. [Link] 
  2. Cayé-Thomasen P, Andersen J, Uzun C, Hansen S, Tos M. Ten-year results of cartilage palisades versus fascia in eardrum reconstruction after surgery for sinus or tensa retraction cholesteatoma in children. Laryngoscope. 2009;119(5):944-52. [Crossref]  [PubMed] 
  3. Schilder AG, Bhutta MF, Butler CC, Holy C, Levine LH, Kvaerner KJ, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol. 2015;40(5):407-11. [Crossref]  [PubMed]  [PMC] 
  4. Swarts JD, Alper CM, Luntz M, Bluestone CD, Doyle WJ, Ghadiali SN, et al. Panel 2: Eustachian tube, middle ear, and mastoid--anatomy, physiology, pathophysiology, and pathogenesis. Otolaryngol Head Neck Surg. 2013;148(4 Suppl):E26-36. [Crossref]  [PubMed] 
  5. Bluestone CD, Doyle WJ. Anatomy and physiology of eustachian tube and middle ear related to otitis media. J Allergy Clin Immunol. 1988;81(5 Pt 2):997-1003. [Crossref]  [PubMed] 
  6. Verhoeff M, van der Veen EL, Rovers MM, Sanders EA, Schilder AG. Chronic suppurative otitis media: a review. Int J Pediatr Otorhinolaryngol. 2006;70(1):1-12. [Crossref]  [PubMed] 
  7. Takasaki K, Takahashi H, Miyamoto I, Yoshida H, Yamamoto-Fukuda T, Enatsu K, et al. Measurement of angle and length of the eustachian tube on computed tomography using the multiplanar reconstruction technique. Laryngoscope. 2007;117(7):1251-4. [Crossref]  [PubMed] 
  8. Salviz M, Bayram O, Bayram AA, Balikci HH, Chatzi T, Paltura C, et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx. 2015;42(1):20-3. [Crossref]  [PubMed] 
  9. Odat H, Alali M, Kanaan Y, Al-Qudah M. Success rate of type 1 tympanoplasty: a comparative study. J Laryngol Otol. 2021;135(4):315-9. [Crossref]  [PubMed] 
  10. Becvarovski Z, Kartush JM. Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI). Laryngoscope. 2001;111(10):1806-11. [Crossref]  [PubMed] 
  11. Yegin Y, Çelik M, Şimşek BM, Olgun B, Karahasanoğlu A, Kayhan FT. The effect of the angle and length of the eustachian tube on the success rate of cartilage Type 1 tympanoplasty. J Craniofac Surg. 2017;28(1):e5-e8. [Crossref]  [PubMed] 
  12. Sadler-Kimes D, Siegel MI, Todhunter JS. Age-related morphologic differences in the components of the eustachian tube/middle ear system. Ann Otol Rhinol Laryngol. 1989;98(11):854-8. [Crossref]  [PubMed] 
  13. Dinç AE, Damar M, Uğur MB, Öz II, Eliçora SŞ, Bişkin S, et al. Do the angle and length of the eustachian tube influence the development of chronic otitis media? Laryngoscope. 2015;125(9):2187-92. [Crossref]  [PubMed] 
  14. Nemade SV, Shinde KJ, Rangankar VP, Bhole P. Evaluation and significance of Eustachian tube angles and pretympanic diameter in HRCT temporal bone of patients with chronic otitis media. World J Otorhinolaryngol Head Neck Surg. 2018;4(4):240-5. [Crossref]  [PubMed]  [PMC] 
  15. Emir H, Ceylan K, Kizilkaya Z, Gocmen H, Uzunkulaoglu H, Samim E. Success is a matter of experience: type 1 tympanoplasty : influencing factors on type 1 tympanoplasty. Eur Arch Otorhinolaryngol. 2007;264(6):595-9. [Crossref]  [PubMed] 
  16. Seibert JW, Danner CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am. 2006;39(6):1221-35. [Crossref]  [PubMed] 
  17. Sato H, Nakamura H, Honjo I, Hayashi M. Eustachian tube function in tympanoplasty. Acta Otolaryngol Suppl. 1990;471:9-12. [Crossref]  [PubMed] 
  18. Takahashi H, Sato H, Nakamura H, Naito Y, Umeki H. Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty. Auris Nasus Larynx. 2007;34(2):173-6. [Crossref]  [PubMed] 
  19. Gulustan F, Gunes S, Yildiz O, Yazici M, Abakay MA, Inci E, et al. Relationship between eustachian tube dimensions and middle ear cholesteatoma. ENT Updates 2020;10(2):355-60. [Crossref] 
  20. Vivek S, Menon UK, Sandya CJ, Polson AM. Study of the reliability of high resolution CT scan evaluation of eustachian tube as predictor of predisposition for chronic otitis media. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 1):332-8. [Crossref]  [PubMed]  [PMC] 
  21. Aksoy S, Sayin I, Yazici ZM, Kayhan FT, Karahasanoglu A, Hocaoglu E, et al. The evaluation of the angles of Eustachian tubes in the patients with chronic otitis media on the temporal computerized tomography. Niger J Clin Pract. 2016;19(3):318-22. [Crossref]  [PubMed] 
  22. Paltura C, Can TS, Yilmaz BK, Dinç ME, Develioğlu ÖN, Külekçi M. Eustachian tube diameter: Is it associated with chronic otitis media development? Am J Otolaryngol. 2017;38(4):414-6. [Crossref]  [PubMed] 
  23. Prasad KC, Hegde MC, Prasad SC, Meyappan H. Assessment of eustachian tube function in tympanoplasty. Otolaryngol Head Neck Surg. 2009;140(6):889-93. [Crossref]  [PubMed] 
  24. Uzun C, Cayé-Thomasen P, Andersen J, Tos M. Eustachian tube patency and function in tympanoplasty with cartilage palisades or fascia after cholesteatoma surgery. Otol Neurotol. 2004;25(6):864-72. [Crossref]  [PubMed]