​Outcome Of Type 1 Tympanoplasty With Cartilage-Perichondrium Graft In Comparison With Temporalis Fascia

ABSTRACT

OBJECTIVE: To compared the outcome of Type 1 tympanoplasty with cartilage-perichondrium graft in comparison with temporalisfascia graft in terms of post-operative graft take-up and hearing results.MATERIALS AND METHODS: A prospective observational study among 80 patients between 15 and 60 years of age satisfyingthe inclusion criteria with complaints of ear discharge and hearing loss due to COM - mucosal type was conducted. Patientswere grouped in two groups of 40 patients each. Group A patients underwent Type 1 tympanoplasty with temporalis fasciaand Group B with cartilage-perichondrium graft. Patients were followed up for graft uptake, hearing improvement and rate offailure are compared for both the grafts. Graft uptake was assessed at the end of the 1st month, 3rd month, and 6th month,and hearing was assessed at the end of the 6th month with pure tone audiometry.RESULTS: Patients with temporalis fascia graft showed a take-up rate of 80% and cartilage-perichondrium graft of 92.5% by6 months. Among the fascia group, graft failure was seen in 20% (8). One patient had failed take-up of graft and four patientsshowed reperforation. In cartilage group, three patients showed failure of take-up of graft during the 1st month. No patient hadreperforation or retraction. Air-bone gap in fascia group showed a closure to 10 dB in 17.5% (7). In the cartilage group, 10 dBin 25% (10 patient s). In our short-term follow-up of 6 months, we found that cartilage-perichondrial graft reduces the chanceof reperforation and retraction even with variation in middle ear pressure due to eustachian tube catarrh. It gives good takeup rate and comparable hearing result as that of the fascia graft. It does not affect the sound conduction when thinned outto appropriate thickness. It is available from the same surgical field and in sufficient quantity for the closure of the TM defect.Cartilage-perichondrium graft for Type 1 tympanoplasty could be a successful replacement for temporalis fascia giving goodresult with neotympanum.