Cartilage Graft In Tympanoplasty

Different methods and grafting materials have been used in tympanoplastic surgery. Grafting materials initially were of epidermal origin, and later various mesenchymal tissues were used.Temporalis fascia and perichondrium remain the most commonly used materials. However, in certain conditions such as large perforations and revision tympanoplasty, fascia and perichondrium often undergo atrophy and subsequent failure in the postoperative period. Cartilage has been shown as a promising material in tympanoplasty. Although it is similar to fascia and perichondrium as being mesenchymal tissue, it is more rigid quality tends to resist resorption and retraction. In this study, 4 types of cartilage grafting techniques were used namely palisade, island, ring and cartilage shield in performing type I tympanoplasty in all cases.Our study included 40 patients suffering from mucosal type of chronic suppurative otitis media with medium, subtotal and total tympanic membrane perforations. The patients were classified into 4 groups (10 patients in each group). Audiological assessment was performed 3 and 6 months postoperatively. Evaluation of hearing in all patients was based on the 6 months postoperative audiogram. The cases were considered successful if the air-bone gap at the speech frequencies 500, 1000, 2000, 4000 Hz was decreased 10db or less. There were statistical significant difference in hearing gain and graft taking success rate among the 4 groups. Comparing the present results with those of other researches using the same techniques, revealed that they are almost similar regarding success rate and graft taking.