Comparative Analysis of Fascia Lata and Cartilage Graft in Revision Type 1 Tympanoplasty.

Abstract

To evaluate graft epithelialization and hearing outcome in type 1 revision tympanoplasty using fascia lata and cartilage as graft material. In this study 33 revision cases of dry central perforations were divided into two groups, group 1 (n=21) in which cartilage was used as a graft and group 2 (n=12) in which fascia lata was used. Group 1 patients were divided according to the technique used as group 1a (n=16) cartilage perichondrium composite island graft and group 1b (n=5) cartilage butterfly inlay graft. Patients were followed up for at least 12months postoperatively, mean 15.63 (±4.21) months. Outcome among the two groups were measured and compared in terms of graft epithelization and hearing improvement measured as the difference between pre and post operative mean air bone gap (ABG) at 1year. The graft epithelialization of group 1 was 85.72% (87.5% group 1a/80% group 1b) and of group 2, 83.34%. Statistically no significant difference was found in the success rate between the two groups (p=0.6). No significant difference was found in the hearing outcome as well (p=0.44). The overall hearing improvement was significant in both groups (p=<0.001) including the sub groups 1a and 1b separately. 21 out of 33 patients (63.63%) operated had a mean postoperative ABG of 20db or less. The results of cartilage and fascia lata as graft are comparable in terms of graft epithelialization and hearing outcome in revision tympanoplasty.