Comparison of Outcomes of Myringoplasty with Cartilage Palisades and Temporalis Fascia in Large Perforations

Abstract

Objectives: Compare graft uptake rate and postoperative hearing results of myringoplasty using cartilage palisades and temporalis fascia in large perforations. Methods: Prospective, longitudinal, randomized controlled trial from December 2010 to December 2012. at the Ganesh Man Singh Memorial Academy of ENT-Head and Neck Studies, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal. Patients were above 13 years of age with chronic otitis media-mucosal (tubotympanic) with >50% perforation of tympanic membrane. Sixty-one cases included for myringoplasty were randomly divided into 2 groups, cartilage palisades and temporalis fascia, by lottery. There were 30 cases in cartilage palisades group and 31 cases in temporalis fascia group. Patients underwent myringoplasty using either cartilage palisades or temporalis fascia. Graft uptake rate and postoperative hearing were evaluated after 12 weeks. Fisher exact test and t test were used as statistical tools. Results: Graft uptake rate in the cartilage palisades group was 86.66% and 90.32% in the temporalis fascia group, with no significant difference ( P = .707) between the 2 groups. The mean pre- and postoperative air bone gaps in the cartilage palisades group were 29.26 dB ± 10.66 and 20.41 dB ± 10.54, respectively. Similarly, in the temporalis fascia group, these were 29.52 ± 11.12 dB and 17.93 ± 8.83 dB, respectively. There was no statistical significance in hearing improvements between the 2 groups ( P = .384). Conclusions: The graft uptake rate and hearing results of myringoplasty with cartilage palisades are comparable to those of temporalis fascia in large perforations.