Cartilage Graft in Myringoplasty: What Are the Factors Influencing Hearing Gain?

Abstract

Background and Objectives:We present the anatomical and functional results on the use of cartilage in myringoplasty and use the data to analyze the factors influencing hearing gain. Subjects and Methods: This retrospective study included 161 cases of cartilage myringoplasties collected over an 11-year period (2010-2020). Of the 161 cases, the etiology of the tympanic perforations was simple chronic otitis media in 154 (95.65%) ears and traumatic in 7 (4.35%) ears. The mean preoperative Rinne was 26.20±7.05 dB. The most commonly used approach was retroauricular, and the common graft material was tragal or conqual cartilage. Results: After the follow-up period (mean:15 months), the anatomical success rate was 93.2%; there were nine cases of reperforation, of which three were reoperated with a good final result. The hearing success rate (residual Rinne ≤20 dB) was 91.9% with an average gain of 11.48 ± 8.62 dB. The only factor significantly influencing the anatomical outcome was the history of chronic rhinosinusitis. In univariate studies, several factors influencing the functional result were revealed; the only one retained after elimination of bias was the anatomical result. Conclusions: We recommend cartilage as the material of choice for myringoplasties as it has been shown to be resistant to predictive factors of failure after tympanic repair surgery. We recommend the adequate management of all chronic rhinosinusitis before performing myringoplasty.

Cartilage’s Contribution in Otology: A Comprehensive Review of Its Role in Ear Surgery

“…Beyond its effectiveness in primary cases, this technique has proven beneficial in addressing recurrent perforations, adhesive otitis media, tympanic membrane retractions, and other mixed middle ear pathologies [ 44 ]. In myringoplasty, a retrospective study encompassing 161 cases highlighted the prevalence of the retroauricular approach and identified tragal or conqual cartilage as the frequently utilized graft material [ 45 ]. Notably, concerns regarding cartilage stiffness were dispelled, with the study reporting satisfactory functional outcomes [ 45 ].…”

“…In myringoplasty, a retrospective study encompassing 161 cases highlighted the prevalence of the retroauricular approach and identified tragal or conqual cartilage as the frequently utilized graft material [ 45 ]. Notably, concerns regarding cartilage stiffness were dispelled, with the study reporting satisfactory functional outcomes [ 45 ].…”