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
Işıl TAYLAN CEBİa, Abdullah KARATAŞa, Nurdan GÖÇGÜNb, Behice Kaniye YILMAZb,
Ali Taha GÖÇERa
aClinic of Otorhinolaryngology, Head and Neck Surgery, Haseki Training and Research Hospital, İstanbul, Türkiye
bClinic of Radiology, Haseki Training and Research Hospital, İstanbul, Türkiye
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.
Keywords: Eustachian tube; myringoplasty; tympanoplasty; tympanic membrane perforation; diagnostic imaging
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.
Anahtar Kelimeler: Östaki tüpü; miringoplasti; timpanoplasti; timpanik membran perforasyonu; tanısal görüntüleme
KAYNAKLAR
- Wullstein HL. Functional operations in the middle ear with split-thickness skin graft. Arch Otorhinolaryngol. 1952;161:422-35. [Link]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- Seibert JW, Danner CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am. 2006;39(6):1221-35. [Crossref] [PubMed]
- Sato H, Nakamura H, Honjo I, Hayashi M. Eustachian tube function in tympanoplasty. Acta Otolaryngol Suppl. 1990;471:9-12. [Crossref] [PubMed]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]