Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

Abstract

The purpose of this study was to compare the success rates and hearing outcomes of transcanal composite chondroperichondrial cartilage graft with that of underlay temporal muscle fascia (TMF) graft for myringoplasty. In this retrospective study, the medical records of patients who underwent type 1 myringoplasty between September 2015 and February 2018 at Otorhinolaryngology Department of Erzurum Ataturk University were reviewed. Demographic properties, preoperative otological findings, preoperative pure ton audiogram findings, postoperative pure ton audiogram findings, and duration of surgeries were reviewed from medical records. The patients with lack of one or more of these information at medical records or lost to at least 3 months of follow-up were excluded from the study. According to the graft material used in the operation, the patients were divided into 2 groups. The patients operated with cartilage graft by transcanal composite chondropericondrial cartilage graft myringoplasty (TCM) technique was regarded as first group, while patients operated with temporal fascia was regarded as the second group (TMF). Both groups were compared according to preoperative and postoperative air–bone gap (ABG), graft acceptance rate, and duration of operation using SPSS version 20.0 software. A total of 113 patients whose medical records met the inclusion criteria were included in the study. Of these, 59 underwent TCM and 54 underwent TMF myringoplasty. Tympanic membrane perforation closure success rate was higher in the cartilage group (94.9%) than in the fascia group (83.3%; P = .046). In the former, preoperative and postoperative ABG was 19.5 ± 5 and 10.8 ± 4.8 dB, respectively. In the latter, the corresponding values were 20.7 ± 5.4 and 11.5 ± 5.4 dB, respectively ( P < .05). Duration of surgery was 29.5 ± 3.4 minutes in the TCM group and 61.5 ± 6.0 minutes in the TMF group ( P < .05). Transcanal cartilage myringoplasty could be considered as an appropriate surgical option because of its simplicity, shorter operation time, and rapid patient recovery, with no significant difference in terms of hearing outcomes compared to temporal fascia.