Primary Cartilage Tympanoplasty: Our Technique And Results.(dr Mubarak Khan,pune) Am J Otolaryngol. 2010 Sep 9. [epub Ahead Of Print]primary Cartilage Tympanoplasty: Our Technique And Results.khan Mm, Parab Sr.abstractcartilage Has Shown To Be A Promising Graft Material To Close Tympanic Membrane Perforations. However, Due To Its Rigid Quality, Doubts Are Raised Regarding Its Sound Conduction Properties. It Has Been Suggested That Acoustic Benefit May Be Obtained By Thinning The Cartilage. We Describe Our Innovative Method For Harvesting Tragal Cartilage From The Same Endaural Incision And Also Describe Preparation Of The Graft By Slicing It. We Present Our 3-year Experience Of Shield Cartilage Type 1 Tympanoplasty Using Sliced Tragal Cartilage-perichondrium Composite Graft.aim: The Aim Of This Study Was To Prove The Success Rate Of Our Technique Of Shield Cartilage Tympanoplasty Using Sliced Tragal Cartilage Graft In Terms Of Functional And Anatomic Results.study Design: Retrospective Analysis Of Type 1 Cartilage Tympanoplasties Using Sliced Tragal Cartilage Was Carried Out In Mimer Medical College And Sushrut Ent Hospital During May 2005 To January 2008 With A Minimum Follow-up Of 2 Years.method And Materials: A Total Of 223 Ears Were Operated By Our Technique.results: The Overall Success Rate Of Our Technique Was 98.20% In Terms Of Perforation Closure And Air Bone Gap Closure Within 7.06 ± 3.39 Db. The Success Rates In The Various Age Group Are As Follows: 11 To 20 Years, 97.67%; 21 To 40 Years, 99.12%; And 41 To 60 Years, 96.96%.conclusion: Our Technique Of Type 1 Cartilage Tympanoplasty Achieves Good Anatomic And Functional Results.

As A Counsellor, I Am Fortunate (?) To Experience A Varied Gamut Of Human Relationships Through The Cases That Come To Me For Therapy.one Such Case Was That Of A Young Adolescent Boy, Who Was Referred To Me For Academics, As Well As Behavioural Issues. On Meeting The Boy, He Seemed Compliant Enough For The Questions And Answered Them Willingly, But I Could Sense Intense Rage Within Him. On Probing, I Found That His Primary Anger Was Directed Against His Mother. Reason? She Insults Him In Front Of His Uncle And The Servant! The Mother Looked Surprised That This Was A Topic Of Dissent With The Boy. Her Logic Was That If He Is Scolded In Front Of Someone Else, Then He Would Learn To Behave Better. When I Asked Her What Her Expectations Were She Had Only One Thing To Say: I Want Him To Respect Elders.i Found Her Need To Be Very Amusing… Considering She Was Using Humiliation As A Tool To Discipline Her Son.everybody Has This Need In Them To Be Respected, Whether Young Or Old. How Could The Mother Expect The Child To Develop A Sense Of Respect And Reverence, When Everytime She Would Deride And Belittle Him Not Only In The Privacy Of Their Home But Also In Public? It Is, According To Me, The Lowest Form Of Disciplining Tactics, Which Would Have The Person At The Receiving End Seething Inside With Humiliation. I Remember, When I Was Working In A Publication Firm, We Would Have This Monthly Meetings, Which Were Called “hall Of Shame”. The Names Of All Those Editors Who Had Not Met Their Targets Would Be Written On The Board, And They Would Be Asked For Detailed Feedbacks And Explanations. This Could Also Be Done In The Cabins Of The Senior Professionals, But I Think They All Got A Perverse Pleasure, Seeing Them Squirm In Front Of An Audience. What Irreparable Damage Was Being Done To The Psyche Of The Person, I Dread To Think. A Personal Memo Calling The Person Filthy Names Is So Much Better Than This Public Flogging. Coming Back To The Case, When I Started Handling The Issues With The Mother, I Could Understand Where She Was Coming From. She Was A Perfectionist, And Theirs Was The Most Passive Marriage I Have Ever Seen! When Asked If She Expected Others To Respect Her As A Person And Her Opinions, She Wanted To Know What I Was Talking About! For The Husband, She Was Just A Wife; One Who Took Care Of His Physical And Biological Needs. He Could Not Describe The Person That She Was: Her Identity Was That She Was His Wife. She Was Labelled A Bad Mother Because Her Son Did Not Behave ‘properly’. So To Get Social Approval She Was Being Punitive With The Son. Her Life Revolved On Social Approvals. She Could No Longer Establish Her Own Identity, And Establishing The Importance Of Being Herself Became The Focus Of Counselling. She Was Gradually Able To Understand That You Do Not Demand Respect; You Command It. And You Can Only Teach How To Respect If You Practise It. The Point Took A While To Sink In; But When She Was Able To Withdraw From The Controlling Relationship, And Also Refused To Take Responsibility For Her Son’s Misbehaviour, And Refuse To Accept The Label Of Being A ‘bad Mother’ Simply Because He Misbehaved, Things Started Turning Around. When People Around Realised That She Was Not Accepting The Blame For His Behaviour, They Started Handling The Boy Differently; And He Too, In Subsequent Sessions Was Able To Understand The Scenario. Sessions Are Still On; The Husband Continues To Be Passive, Though He Is Beginning To Think There Is More To A Marriage Than Just Staying Together, And Is Slowly Willing To Enrich The Relationship.it Is Not ‘all Is Well’ As Yet…. But I Hope It Would Be.mohana Narayanan

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