Cartilage support for fascia graft in type I tympanoplasty.

Abstract

To evaluate the success rate, in terms of anatomical and functional results, in our technique of cartilage support for fascia graft in type I tympanoplasty. Retrospective study of tragal cartilage support for fascia graft in tympanoplasty for large central perforation in 748 patients was carried at an academic institution during January 2004 to March 2012. Patients' age ranged from 11 to 65years. 325 (43.4%) male and 423 (56.6%) female patients were operated and mean post-operative follow up was of 24months (range 6-48months). The inclusion criteria were large central or subtotal perforation, anterior quadrant perforation, anterior tympanosclerotic patch with perforation and revision myringoplasty. Small central perforation, posterior perforations, traumatic perforations and Ossiculplasty were excluded from this study. In this technique, a piece of tragal cartilage carved in semi lunar shape is inserted medial to anterior remnant of tympanic membrane. Temporalis fascia graft is sandwiched between cartilage and anterior remnant of tympanic membrane. Post-operative closure of perforation was noted. Pure-tone average pre and post-operative air-bone gap in dB at 250, 500, 1000, 2000, and 4,000Hz were compared. The overall success rate of our technique was 98.3% in terms of graft uptake and within 13.35±5.22dB of air bone gap closure in terms of hearing improvement. This study reveals that cartilage support for fascia graft in type I tympanoplasty is a highly reliable technique and gives significant improvement in graft take-up and hearing status.