Tympanoplasty with Island Cartilage or Temporalis Fascia: A Comparative Study

Abstract

Purpose: To compare clinical and audiological outcomes of the type 1 tympanoplasties where conchal cartilage (island graft) and temporalis fascia were used as the graft material. Procedures: In this retrospective study, the results of type 1 tympanoplasty operations (n = 50) in which cartilage and temporalis fascia were used for graft material were compared. Results: Pre- and postoperative otoscopic findings of both groups were similar (p > 0.05). Preoperatively, the pure tone averages (PTAs) and hearing thresholds of the fascia and cartilage groups were similar (p > 0.05). However, postoperatively, the PTAs and air-bone gap closure were better with temporalis fascia compared to cartilage grafting (p < 0.05). On frequency-specific comparisons, the pure tone thresholds at the frequencies of 0.5, 1 and 2 kHz recovered better with temporalis fascia compared to cartilage (p < 0.05). Although the pure tone recovery was better at 4 kHz with temporalis fascia, the difference between the groups were not significantly different (p > 0.05). Conclusion and Message: In conclusion, in contrast to many reports in the literature, temporalis fascia grafting seems better in our study than grafting with conchal cartilage.

Comparison of cartilage with temporalis fascia tympanoplasty: A meta‐analysis of comparative studies

“…A total of 37 articles were finally included in our meta‐analysis, resulting in a pooled population of 3,606 patients: 1,795 undergoing cartilage tympanoplasty and 1,811 undergoing fascia tympanoplasty. There were 11 PCSs, three of which were randomized .…”

“…There were 11 PCSs, three of which were randomized . The remaining 26 comparative studies were retrospective . Three prospective studies and 12 retrospective studies were considered as low‐bias studies (see the online Supporting Table SI about the characteristics of the included studies).…”

“…Data regarding graft integration rate (Fig. ) were available for 35 eligible articles (11 prospective studies and 24 retrospective studies). Fifteen of them were at low risk of bias (score ≥ 5 in the quality assessment).…”

“…Regarding island tympanoplasty (group E), data about graft integration rate, ABG closure of < 10 dB, and postoperative mean ABG were available for 18, 7, and 11 studies, respectively. The graft integration rate resulted in a statistical significance (RD = 0.11; 95% CI [0.08; 0.14]; P < 0.001).…”

“…Overall, eight studies presented results in only adults. Palisade (group A), thin and thick plate (group B), island (group C), and island (group E) techniques were used. The graft integration rate resulted in a statistical significance (RD = 0.13; 95% CI [0.03; 0.23]; P = 0.008).…”