Results of inlay cartilage myringoplasty in terms of closure of central tympanic membrane perforations

Abstract

There is a current effort to perform myringoplasty for tympanic membrane perforations as a day-stay procedure. In 1998, an inlay myringoplasty using tragal cartilage/perichondrium was described. A retrospective study was performed by the author to analyse the results of inlay cartilage myringoplasty, in terms of closure of simple perforations of the tympanic membrane. The results of a control group of previous cases of underlay temporalis fascia myringoplasty were retrieved from the hospital records. All the operations in both groups were performed by the same author at the same institution. The operation of inlay cartilage butterfly myringoplasty has been performed in 28 ears with simple central tympanic membrane perforations. Inconsistent results have been obtained, in that only 43 per cent showed closure of the perforation at the most recent follow-up. A control group of standard underlay temporalis fascia myringoplasty has been performed by the same author in 23 ears. Eighty-three per cent of the perforations were closed at the last follow-up. The difference is statistically highly significant (p < 0.01).

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).…”

Hearing Outcome After Type I Tympanoplasty: A Retrospective Study

“…Even with advancement and newer graft materials [14][15][16][17][18][19][20], temporalis fascia remains a widely used graft by many surgeons which yields good take up rates and acceptable hearing results as in this study. …”

“…Many studies have been conducted to compare the hearing results of patients with cartilage tympanoplasty, using perichondrium and it was concluded that hearing results after cartilage tympanoplasty are comparable to temporalis fascia and perichondrium [14][15][16], but results of cartilage tympanoplasty were not good by some authors [17]. Recently in many studies alloderm and human amniotic membrane have also proved to be an effective TM graft when used in type I tympanoplasty [18][19][20].…”

Author's Comments and Recommendations

“…25.14) may take longer or may even be impossible if the space between the wing and the graft is occupied by keratin. My skepticism was confirmed by Effat (2005), who reported poor results 23 months (range 8-38 months) after in-lay butterfly tympanoplasty performed during a period from 2001 to 2004 on 21 patients (28 ears) with simple and dry, small and middle-sized perforations. At the follow-up only 43 % of ears showed closure of the perforation.…”