Hearing Results after Tympanoplasty Type I with Cartilage-Perichondrium Composite Island Graft

Kang, Dae Hyoung; Park, Hyo Sang; Kim, Seung Tae; No, Yong Hyeon; Cha, Yong Woo; Kim, Joo Yeon; Lee, Hwan Ho

Abstract

BACKGROUND AND OBJECTIVES
Many materials such as fascia, perichondrium and cartilage are used for reconstruction of the tympanic membrane in middle ear surgery. Because of its stiffness, cartilage is resistant to resorption and retraction. However, cartilage grafts result in increased acoustic impedance, so its use has caused controversies as to the acoustic transfer aspect. The aim of this study is to assess hearing results after cartilage tympanoplasty and after fascia tympanoplasty.
SUBJECTS AND METHOD
This study included 74 patients who had received tympanoplasty type I between 2007 and 2009, of whom 44 received cartilage and 30 fascia. The middle ear risk index was used to statistically compare the preoperative state of the two groups. Preoperative and six months- postoperative air-bone gaps at the frequency 0.5, 1, 2 and 3 kHz were assessed.
RESULTS
Both groups were statistically similar with respect to the severity of middle ear pathology and the preoperative hearing levels. Overall postoperative hearing results showed air-bone gaps (ABG) < or =20 dB in 73% for the fascia group and 71% for the cartilage group. The mean postoperative gains in ABG were 8.97 dB for the fascia group and 10.84 dB for the cartilage group. There were no statistically significant differences in the postoperative frequency specific gains in ABG between the two groups.
CONCLUSION
These results demonstrate that hearing results after cartilage tympanoplasty are comparable to those after fascia tympanoplasty. Although cartilage is the ideal grafting material in problem cases, a more liberal application might be suggested in such cases as in tympanoplasty type I without fear of impairing hearing.