Reinforcement of the Anterior Annulus by Overlay Conchal Cartilage in Temporalis Fascia Grafting for Subtotal and Total Perforations.

Abstract

Objectives: In this study, the graft success and hearing improvement were compared in patients with subtotal or total tympanic membrane perforations following conchal cartilage-reinforced temporalis fascia graft tympanoplasty (CCRTT) versus traditional tragal island cartilage tympanoplasty (TICT). Material and Methods: Fifty Type 1 tympanoplasties performed for subtotal or total tympanic membrane perforation were classified into 2 groups: CCRTT consisted of 23 patients and TICT consisted of 27 patients. The difference between these 2 groups was analyzed by means of graft success, reperforation, and postoperative hearing gain after 12 months. Results: The graft success rate was 96.3% in TICT group and 91.3% in CCRTT group and there was no statistical difference between 2 groups (P > .05). Postoperative pure tone average (PTA) gain was 12.9 ± 9 dB for TICT group and 14 ± 8.8 dB for CCRTT group and postoperative air-bone gap (ABG) gain was 11.2 ± 7.7 dB in TCIT group and 11.3 ± 8.5 dB in CCRTT group and again, there was no statistical difference between these 2 study groups considering PTA and ABG gain (P > .05). Conclusion: Reinforcing tympanic membrane by conchal cartilage in an overlay technique under the anterior tympanic annulus by CCRTT in subtotal and total perforations is as effective as traditional TICT. Considering that graft success is lower in subtotal and total tympanic membrane perforations, both methods can be used interchangeably, depending on the choice of the surgeon.