Repair of subtotal tympanic membrane perforation by ultrathin cartilage shield: evaluation of take rate and hearing result

Abstract

Our aim is to evaluate the function and take rate of 0.2 mm thickness cartilage shield for repair of subtotal tympanic membrane perforation by comparing it with full thickness cartilage and temporalis fascia. Repair of tympanic membrane was done in 85 patients with unilateral chronic otitis media with subtotal perforation. The patients were classified into three groups: group 'A' where 0.2 mm thickness cartilage graft was used, group 'B' repaired with full thickness cartilage graft and group 'C' where temporalis fascia graft was used. Over the follow-up period, we found that the graft take was complete with both partial and complete thickness cartilage grafts while it was not complete in fascia cases. On the other hand, there was marked improvement in hearing in cases repaired by fascia and partial thickness grafts as compared to hearing results of full thickness grafts. We concluded that 0.2 mm partial thickness cartilage graft is optimal in reconstruction of subtotal tympanic membrane perforation because it is excellent to obtain high take rate with good hearing results.

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 . The remaining 26 comparative studies were retrospective .…”

“…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).…”

“…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).…”

Comparison of Partial Thickness and Full Thickness Tragal Cartilage Graft During Modified Cartilage Shield Tympanoplasty for Type I Procedures

“…Yung [12] in 2008 have mentioned from literary review that concerns that the stiffness and mass of cartilage grafts may adversely affect hearing have not been substantiated in clinical reports thus far. Mokbel et al [13] have used ultrathin cartilage and concluded that the hearing results of 0.2 mm partial thickness cartilage are more or less similar to that of temporalis fascia which is little better.…”

Minimally invasive endoscopic transcanal cartilage myringoplasty is the treatment of choice for repair of anterosuperior perforations

“…Cartilage myringoplasty has replaced temporalis fascia myringoplasty when anterior and subtotal perforations are to be repaired; the long-term success rates are higher when the former technique is employed. Mokbel et al [8] performed ultrathin cartilage shield myringoplasty and reported that the take rate was 100% in those with partial-thickness cartilage shields, 100% in those with full-thickness shields, and 60% in a fascia group. Shishegar et al [9] reported the graft take rate was 100% when palisade cartilage was placed in patients with subtotal perforations, compared to 92.5% in a fascia group.…”