Cartilage reinforcement graft versus fascia graft in tympanoplasty

Cartilage reinforcement graft versus fascia graft in tympanoplasty

Background/aim: The purpose of this study was to compare cartilage reinforcement graft results with temporalis fascia graft alone in terms of hearing and anatomical outcomes in tympanoplasty. Materials and methods: Patients who underwent tympanoplasty with/without ossiculoplasty and/or mastoidectomy at a university hospital from 2006 through 2013 were reviewed retrospectively. The patients were divided into those grafted with temporalis muscle fascia alone and with fascia reinforced with cartilage. The postoperative air bone gap, gain in hearing thresholds, and graft status were evaluated for each group. Results: The study subjects included 179 patients. There were 82 patients in the fascia group and 97 patients in the cartilage group. Successful hearing results were elicited in 79.2% of the fascia group and 85.5% of the cartilage group. There was no significant difference in overall graft success. The graft was intact in 82.9% of the fascia group and 86.5% of the cartilage group. Conclusion: In this comparative study the use of cartilage to reinforce the temporalis muscle fascia was analyzed, showing better hearing and anatomical results than sole use of fascia in tympanoplasty both for primary and revision cases. Thus, in the light of our results, when performing tympanoplasty we recommend the use of cartilage reinforcement grafting whenever needed and indicated.

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  • 1. Shea JJ. Vein graft closure of eardrum perforations. J Laryngol Otol 1960; 74: 358-362.
  • 2. Tabb HG. Closure of perforations of the tympanic membrane by vein grafts: a preliminary report of 20 cases. Laryngoscope 1960; 70: 271-274.
  • 3. Herman H. Tympanic membrane plastic repair with temporalis fascia. Hals Nas Ohrenh 1960; 9: 136-139.
  • 4. Salen B.  Tympanic membrane grafts of full-thickness skin, fascia and cartilage with its perichondrium, an experimental and clinical investigation. Acta Otolaryngol Suppl Stockh 1968; 244: 5-73.
  • 5. Glasscock ME,  House WF.  Homograft reconstruction of the middle ear. Laryngoscope 1968; 78: 1219-1225.
  • 6. Utech H. Ueber diagnostische und therapeutische Moeglichkeiten der Tympanotomie bei Schalleitungsstoerungen. Laryngol Rhinol 1959; 38: 212-221.
  • 7. Saraç S. Anteriorda Kıkırdak ile Güçlendirilmiş Timpanoplasti. In: Önerci M, editor. Kulak Burun Boğaz Baş ve Boyun Cerrahi’sinde Güncel Yaklaşım. Ankara, Turkey: Hacettepe Üniversitesi Hastaneleri Basımevi; 2005. pp. 44-45.
  • 8. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngology head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery 1995; 113: 186-187.
  • 9. Brackmann DE, Sheehy JL. Tympanoplasty: TORPS and PORPS. The Laryngoscope 1979; 891: 108-114.
  • 10. Yang T, Wu X, Peng X, Zhang Y, Xie S, Sun H. Comparison of cartilage graft and fascia in type 1 tympanoplasty: systematic review and meta-analysis. Acta Otolaryngol 2016; 136: 1085- 1090.
  • 11. Jiang Z,  Lou Z. Effects of perforation size on the success rate of  tympanoplasty  using a  cartilage  graft. Braz J Otorhinolaryngol. 2016 Nov 17. pii: S1808-8694(16)30228-2.
  • 12. Lyons SA, Su T, Vissers LE, Peters JP, Smit AL, Grolman W. Fascia compared to one-piece composite  cartilageperichondrium grafting for  tympanoplasty. Laryngoscope 2016; 126: 1662-1670.
  • 13. Kazikdas KC, Onal K, Boyraz I. Palisade cartilage tympanoplasty for management of subtotal perforations: a comparison with the temporalis fascia technique. Eur Arch Otorhinolaryngol 2007; 264: 985-989.
  • 14. Demirci S, Tuzuner A, Karadas H, Acıkgoz C, Caylan R, Samim EE. Comparison of temporal muscle fascia and cartilage grafts in pediatric tympanoplasties. Am J Otolaryngol 2014; 35: 796- 799.
  • 15. Khan MM, Parab SR. Comparative study of sliced tragal cartilage and temporalis fascia in type I tympanoplasty. J Laryngol Otol 2015; 129: 16-22.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
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