Tragal cartilage versus tragal perichondrial graft in tympanoplasty type 1

Abstract

Background Chronic suppurative otitis media is a common health problem. It causes tympanic membrane perforation, otorrhea, and conductive hearing loss. Type 1 tympanoplasty is a common otological procedure done to eliminate the infection and improve hearing and quality of life. Objective To compare graft uptake and hearing outcome using autologous grafts (tragal cartilage, temporalis fascia (control group), and tragal perichondrium) in tympanoplasty type 1. Patients and methods A total of 45 patients with chronic suppurative otitis media were included in this comparative study. They were divided into three groups, with 15 patients in each group: group A received tragal cartilage graft, group B received temporalis fascia graft (control group), and group C received tragal perichondrial graft. Patients were subjected to detailed history taking, proper clinical examination, routine blood investigations, audiometry, and tympanometry preoperatively. They underwent underlay tympanoplasty type 1. Postoperative follow-up was done after 3 months by otoscopy to evaluate graft uptake and hearing outcome by audiometry, and results were compared. Results Graft uptake was 93.3% in the cartilage group, 73.3% in fascia (control) group, and 66.7% in perichondrium group. There was hearing improvement in cartilage group than fascia (control) group, which was better than perichondrium group, with no statistically significant difference among the three groups regarding graft uptake (P=0.188) or hearing gain. Conclusion Graft uptake and hearing improvement were better with tragal cartilage graft in comparison with fascia (control group) and perichondrium grafts, with no statistically significant difference between them.