Abstract

BackgroundThere are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties.ObjectivesTo compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy.MethodsWe enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane.ResultsThere were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743).ConclusionPerichondrium and fascia were suitable for use in endoscopic tympanoplasties.

Highlights

  • The tympanic membrane bears characteristic anatomical and physical features

  • Perichondrium and fascia were suitable for use in endoscopic tympanoplasties

  • This present study has compared the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. This retrospective study was conducted between January 2015 and July 2017 at our hospital’s ear nose and throat surgery clinic, including a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with middle ear risk index (MERI) scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation

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Summary

Introduction

The tympanic membrane bears characteristic anatomical and physical features. Tympanoplasty is a surgical procedure to reconstruct the tympanic membrane after perforations and to correct hearing losses [1, 2]. Today, varying types of grafts are available for use in tympanoplasties. The types of the grafts to be used vary depending on the experiences and preferences of the surgeons working at different institutions [6, 7]. The fascia of the temporal muscle is the most commonly used graft in primary tympanoplasties with success rates of 6 8-97% for graft retentions [8, 9]. There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties

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