Abstract
ObjectiveTo compare surgical results of endoscopic myringoplasty using double layer cartilage-perichondrium grafts versus single fascia grafts.Study designProspective, randomized, controlled.SettingUniversity-affiliated teaching hospital.Subjects and methodsIn total,134 patients who underwent endoscopic myringoplasty were included in this study. Patients in group A received a double layer tragal cartilage-perichondrium graft and those in group B received a temporal muscle fascia graft. The groups were compared with respect to the pre- and postoperative air-bone gap (ABG) and the graft success rate.ResultsThe graft success rate was 98.5% (66/67) in the Group A and 94.0% (63/67) in the Group B at 6 months, the difference wasn’t statistically significant (p = 0.362). However, the graft success rate was 97.0% (65/67) in the Group A and 85.1% (57/67) in the Group B at 12 months, the difference was statistically significant (p = 0.034).In addition, only one patient (1.49%) had small keratin pearls in the Group A, no patients developed cholesteatoma of middle ear in either group.ConclusionsThe endoscopic double layer perichondrium-cartilage graft technique is feasible for repairing medium or larger perforations, it has a better long-term graft success rate and less operative time compared with the single layer fascia graft technique. However, long-term hearing outcomes were the same for the single and double layer closure techniques.
Highlights
The endoscopic double layer perichondrium-cartilage graft technique is feasible for repairing medium or larger perforations, it has a better long-term graft success rate and less operative time compared with the single layer fascia graft technique
Chronic tympanic membrane (TM) perforation is a common complication of chronic otitis media (COM) and trauma in adult; persistent perforation requires surgical closure by myringoplasty
We introduced a double layer cartilage-perichondrium graft, a novel modified over-underlay technique for the reconstruction of TM
Summary
Chronic tympanic membrane (TM) perforation is a common complication of chronic otitis media (COM) and trauma in adult; persistent perforation requires surgical closure by myringoplasty. Lou Journal of Otolaryngology - Head and Neck Surgery (2020) 49:40 technique is effective in repairing perforations and can achieve excellent hearing outcomes, but requires extensive canalplasty and carries an added risk of TM blunting, lateralization, and excessive TM thickness [7, 8]. We introduced a double layer cartilage-perichondrium graft, a novel modified over-underlay technique for the reconstruction of TM. This technique combines the ease of the underlay technique with the overlay approach, taking tragal cartilage with perichondrium, freeing the edges of the perichondrium, and placing the graft through the perforation, with the cartilage medial to the perforation and the perichondrium lateral. This study compared the anatomical and functional outcomes in TM perforations of double layer cartilage-perichondrium graft and underlay fascia graft via endoscopy
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