Cartilage tympanoplasty with island technique for reconstruction of tympanic membrane perforation: anatomic and audiologic results.

OBJECTIVES: The aim of this study was to evaluate anatomic/audiologic outcomes of cartilage tympanoplasty with island technique and compare the results with the results of temporalis fascia tympanoplasty.

PATIENTS AND METHODS: The charts of 40 patients who underwent surgery for primary type 1 tympanoplasty either with perichondrium-cartilage (12 males, 11 females; mean age 29.7 years; range 12 to 58 years) or fascia graft (9 males, 8 females; mean age 32.4 years; range 13 to 61 years) between January 2006 and January 2008 were retrospectively reviewed. Patients in whom the only pathology was subtotal tympanic membrane perforation with intact ossicular chain were included in the study. Pre- and postoperative audiograms, postoperative otoscopy findings and follow-up time were obtained from the patient's chart in both groups. Reviewed parameters were the complete closure rates of the tympanic membrane perforation and the change in air bone gap at each of four frequencies (0.5, 1, 2, 4 kHz). Audiologic evaluation was made among the patients in whom complete ear drum closure was achieved in both groups.

RESULTS: Anatomic closure rates of the tympanic membrane perforation for perichondrium-cartilage and fascia group were 91.3% and 88.2%, respectively. Pre- and postoperative pure tone average air bone gap obtained at four frequencies for the perichondrium-cartilage and fascia group were 21.3+/-6.7 dB, 9.0+/-3.9 dB, and 21.2+/-6.9 dB, 8.5+/-4.4 dB, respectively. These findings revealed the overall gains of 12.3 dB for the cartilage-perichondrium group and 12.7 dB for the fascia group (p>0.05).

CONCLUSION: The anatomic and audiologic results after cartilage tympanoplasty with island technique are comparable to those after temporalis fascia tympanoplasty. Furthermore, the cartilage is more resistant than the fascia to the anatomic deformation and necrosis. Therefore, we advise its use as a routine tympanic membrane reconstruction material without concern about effecting audiometric resuls.