Full thickness vs sliced mosaic cartilage graft in tympanoplasty: a comparative study

Abstract

BackgroundTympanoplasty is one of the most performed procedures in otorhinolaryngology—head and neck surgery. Reconstruction of hearing is one of its targeted goals (Jeffery et al., J Otolaryngol Head Neck Surg 46:48, 2017). Closure of tympanic membrane was accomplished by various grafts. Temporalis fascia is commonly used in tympanoplasty but it could not withstand pressure variations due to its low elasticity (Sözen et al., J Craniofac Surg 23:e280-e283, 2012). Cartilage was preferred in this condition owing to its rigidity (Zhang et al., Otol Neurotol 32:1234-1238, 2011). However, this rigid character is thought to hinder the acoustic transfer through the cartilage (Bozdemir et al., ORL J Otorhinolaryngol Relat Spec 74:28-32, 2012).This study was conducted to determine the acoustic characteristics of sliced mosaic cartilage tympanoplasty.ResultsComparable success rates were found among the 2 groups at 3 months postoperatively; 14 cases (88%) in group 1 and 20 cases (91%) in group 2. One year postoperatively, two cases with healed perforation in group 2 showed re-perforation; resulting in decreasing success rate to 81%, in contrast to constant success rate (88%) in the corresponding follow-up in group 1. However, the difference between the two groups remained insignificant (P = 1 in both follow ups).ConclusionUsing split thickness cartilage slices arranged in mosaic pattern in type I tympanoplasty successfully overcame the hindering effect of cartilage on acoustic transfer, with no fear regarding take rate or complications.