Cartilage tympanoplasty: A powerful tool in otologic surgery

Cartilage as a graft material in middle ear surgery is widely used mainly when there is need for reinforcement of a retraction area or for rebuilding a scutum erosion. German surgeons since 1970 have been using cartilage stripes and plates in "palisade" technique and, more recently, in a partially overlapping manner with thinned plates in order to overcome the acoustic disadvantages represented by thick cartilage plates. In the present paper the author critically reviews his personal experience with cartilage tympanoplasty performed by using thinned stripes of cartilage partially superimposed as flower petals according to Huttenbrink's suggestion. In his opinion cartilage tympanoplasty seems at the present the best available option when dealing with "difficult" ears ( fibroadesive otitis, atelectatic ears, multiple revision cases) even if at the moment we do not have yet a sufficiently long follow-up.