Island cartilage vs temporalis fascia in type 1 tympanoplasty: A prospective study

Acta Otorrinolaringol Esp (Engl Ed). 2018 Nov-Dec;69(6):311-317. doi: 10.1016/j.otorri.2017.10.004. Epub 2018 Mar 22.
[Article in English, Spanish]

Abstract

Objective: (1) To compare the results of graft take-up and audiological outcome of temporalis fascia versus island cartilage graft in type 1 tympanoplasty. (2) To compare the rate of postoperative retraction of neotympanum in both.

Methods: A prospective study was conducted on 70 patients of ages ranging from 11 to 50 years with dry subtotal perforation. 35 underwent island cartilage tympanoplasty and 35 underwent type 1 tympanoplasty using temporalis fascia graft. Graft acceptance rates and post-operative audiograms were compared.

Results: At one year follow up, the graft take-up rate for temporalis fascia and island cartilage graft were found to be 82.9% and 97.1% respectively, which was found to be statistically significant (p<0.05). In the temporalis fascia group, two out of 35 patients (5.7%) had retraction of the neo tympanum. There was no incidence of retraction using island cartilage graft. There was no significant difference in the postoperative air-bone gap gain between temporalis fascia graft and island cartilage graft.

Conclusion: Island cartilage tympanoplasty shows a high degree of reliability in high risk cases. It has a higher graft take-up rate with no incidence of retraction of neotympanum. Moreover, it provided significant hearing improvement in our patients.

Keywords: Cartilage; Cartílago; Fascia de músculo temporal; Temporalis fascia; Timpanoplastia; Tympanoplasty.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Audiometry, Pure-Tone
  • Bioprosthesis*
  • Bone Conduction
  • Child
  • Double-Blind Method
  • Ear Cartilage
  • Fascia
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Male
  • Middle Aged
  • Myringoplasty / methods*
  • Organ Specificity
  • Prospective Studies
  • Treatment Outcome
  • Tympanic Membrane / ultrastructure
  • Tympanic Membrane Perforation / surgery*
  • Young Adult