Comparison of type I tympanoplasty with acellular dermal allograft and cartilage perichondrium

Acta Otolaryngol. 2019 Oct;139(10):833-836. doi: 10.1080/00016489.2019.1637541. Epub 2019 Jul 16.

Abstract

Background: Acellular dermal allograft (AlloDerm) and cartilage perichondrium are two common materials used for repair of tympanic membrane perforations (TMPs). To date, comparative evaluations of their efficacy have rarely been reported. Aim/objectives: To compare anatomical and audiological outcomes between AlloDerm and cartilage perichondrium in type I tympanoplasty. Methods: A total of 61 patients of TMP were studied. In total, 27 patients (Group 1) underwent AlloDerm myringoplasty, and the remaining 34 patients (Group 2) underwent perichondrium myringoplasty. Operating time, closure rate and hearing gain were compared between Groups 1 and 2. Results: Successful closure rates at 6-month follow-up were 88.9% (Group 1) and 82.4% (group 2). The average improvement of air-bone gap (ABG) was 13.5 ± 11.8 dB for Group 1 and 13.1 ± 13.1 dB for Group 2. The difference in between preoperative and 6 months postoperative ABG values was statistically significant (p < .001). Conclusions and significance: Success rates and improvement of hearing level were similar for the AlloDerm (Group 1) and the cartilage perichondrium (Group 2) groups. However, AlloDerm requires shorter operative time and avoids the incisions in the harvest of allografts. Our results suggest that AlloDerm can be recommended as an attractive alternative to cartilage grafts.

Keywords: AlloDerm; Tympanoplasty; cartilage; tympanic membrane perforation.

Publication types

  • Comparative Study

MeSH terms

  • Acellular Dermis*
  • Adult
  • Cartilage / transplantation*
  • Collagen / therapeutic use*
  • Female
  • Hearing
  • Humans
  • Male
  • Middle Aged
  • Myringoplasty / methods*
  • Retrospective Studies
  • Treatment Outcome
  • Tympanic Membrane Perforation / surgery*
  • Tympanoplasty / methods*

Substances

  • Alloderm
  • Collagen