Cartilage tympanoplasty methods: proposal of a classification.

The 23 known cartilage tympanoplasty methods to reconstruct the eardrum are classified in six main groups. Each method is briefly defined, described, and illustrated: GROUP A: Cartilage tympanoplasty with palisades, stripes, and slices. The eardrum is reconstructed by several, various, full-thickness pieces of cartilage with attached perichondrium on the ear canal side. In this group six different methods are described. GROUP B: Cartilage tympanoplasty with foils, thin plates, and thick plates, not covered with the perichondrium. In this group four methods are included. GROUP C: Tympanoplasty with cartilage-perichondrium composite island grafts. The perichondrium flap suspends or fixates the cartilage. In this group four methods are included. GROUP D: Tympanoplasty with special total pars tensa cartilage-perichondrium composite grafts. All three methods are used to close a total perforation, but differ from each. Three special methods are included in this group. GROUP E: Cartilage-perichondrium composite island grafts tympanoplasty for anterior, inferior, and subtotal perforations. Two on-lay and two underlay methods are included.GROUP F: Special cartilage tympanoplasty methods: The cartilage disc is placed under the perforation, the perichondrium onto the denuded eardrum remnant.