Cartilage Tympanoplasty with Island Technique: A Comparison with the Temporalis Muscle Fascia Technique

Objective; To evaluate hearing results and failures of tympanoplasty techniques with either island cartilage or temporalis muscle fascia. Materials & Methods; Retrospective evaluation of selected cases operated by the same surgery team between 2000 and 2008. A total of 307 patients with a tympanic membrane perforation or retraction due to chronic otitis media were treated surgically with tympanoplasty with or without mastoidectomy. From these 96 cases who had primary repair of tympanic membrane perforation or retraction with intact ossicular chain and normal middle ear were included into the study. Tympanic membrane perforation was reconstructed by using fascia in 36 while cartilage island graft was used in 60 patients. Temporalis muscle fascia was preferred for simple perforations while cartilage was used in more difficult cases such as retractions or total or subtotal perforations. Preoperative and postoperative pure-tone average air-bone gaps were compared at 250, 500, 1000, 2000 and 4000 Hz frequencies. Postoperative failures were compared. Results; Main outcomes of both techniques were similar for hearing results and prevalence of failures. Closure of air-bone gaps after surgery were 14.98, 12.5, 9.67, 8.67, and 7.01 dB for cartilage group and 15.42, 11.67, 8.34, 7.36, and 8.61 dB for fascia group respectively. The differences were not statistically significant. Graft survival rates were 86.1% in the fascia group and 95% in the cartilage group.