Fascia Versus Cartilage Graft in Type I Tympanoplasty

Abstract

Various materials such as fascia, perichondrium, and cartilage have been used for reconstruction of the tympanic membrane in middle ear surgery. Because of its stiffness, cartilage is resistant to resorption and retraction. However, cartilage grafts result in increased acoustic impedance, the main limitation to their use. The aim of this study was to compare the hearing results after cartilage tympanoplasty versus fascia tympanoplasty. This study included 114 patients without postoperative tympanic membrane perforation who underwent tympanoplasty type I between 2007 and 2010, 31 with fascia and 83 with cartilage. Preoperative and 1 year postoperative air-bone gap (ABG) and postoperative gain in ABG at frequencies of 0.5, 1, 2, and 3 kHz were assessed. Both groups were statically similar in terms of the severity of middle ear pathology and the preoperative hearing levels. Overall, postoperative successful hearing results showed 77.4% of the fascia group and 77.1% of the cartilage group. Mean postoperative gains in ABG were 9.70 dB for the fascia group and 9.78 dB for the cartilage group. These results demonstrate that hearing after cartilage tympanoplasty is comparable to that after fascia tympanoplasty. Although cartilage is the ideal grafting material in problematic cases, it may be used in less severe cases, such as in type I tympanoplasty, without fear of impairing hearing.