All Cartilage No Stitch Type 1 Tympanoplasty – A Prospective Study

Abstract

Introduction
 Although temporalis fascia is the commonly used graft material for tympanoplasty, cartilage has become the material of choice in cases with eustachian tube dysfunction, bilateral disease, total or anterior perforation of tympanic membrane, tympanosclerosis etc. Cartilage slices < 0.5 mm thick are similar to the tympanic membrane in their acoustic properties. The present study is aimed to describe stitch-less type 1 tympanoplasty with sliced tragal cartilage-perichondrium and evaluate anatomical, audiological and cosmetic outcomes.
 Materials and Methods 
 A prospective study was conducted from March 2014 to August 2016, in ENT department of a Government Medical College and Hospital, West Bengal, India. Primary tympanoplasty cases irrespective of age, size and site of perforation, laterality and eustachian tube function were included in the study. History of previous tympanoplasty or mastoid surgery and cases requiring ossicular reconstruction or mastoidectomy were excluded from the study. Sliced tragal cartilage-perichondrium graft of 0.2 mm thickness was placed in underlay fashion through trans-canal or end-aural route.
 Results
 Among 95 cases 38 were male, 57 were female with age range between 7 to 68 years. Average operative time was 30 minutes. Graft take was successful in 97.89% of cases. Average Air Bone Gap 12 months after operation was 13.03dB.
 Conclusion
 Sliced cartilage-perichondrium graft gives good balance between sufficient stability and adequate acoustic sensitivity. Moreover, no stitch technique reduces operative time and increases cosmesis.