Comparison of temporalis fascia muscle and full-thickness cartilage grafts in type 1 pediatric tympanoplasties

Publication date: Available online 28 March 2016
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Yakup Yegin, Mustafa Çelik, Arzu Karaman Koç, Levent Küfeciler, Mustafa Suphi Elbistanlı, Fatma Tülin Kayhan
IntroductionVarious graft materials have been used to close tympanic membrane perforations. In the literature, there are few studies in pediatric populations comparing different graft materials. To our knowledge, there is no reported study that measured the thickness of the tragal cartilage in pediatric tympanoplasties. The tragal cartilage is not of uniform thickness in every patient.ObjectiveTo compare anatomical and functional outcomes of temporalis fascia muscle and full-thickness tragal cartilage in type 1 pediatric tympanoplasties.MethodsIn total, 78 patients (38 males, 40 females; average age 10.02±1.98 years; range 7–18 years) who underwent type 1 tympanoplasties in our clinic were included. Demographics, anatomical and functional outcomes were collected. Temporalis fascia muscle and tragal cartilage were used as graft materials. Tragal cartilage was used without thinning, and the thickness of tragal cartilage was measured using a micrometer. Anatomical and functional outcomes of cartilage and fascia were compared. Audiometric results comparing the cartilage and fascia groups were conducted at six months, and we continued to follow the patients until one year after the surgery. An intact graft and an air-bone gap (ABG) ≤20dB were regarded as a surgical success. Results with a p-value<0.05 were considered statistically significant.ResultsThe graft success rate was 92.1% for the cartilage group compared with 65.0% for the temporal fascia group. In the fascia group, the preoperative ABG was 33.68±11.44dB, and postoperative ABG was 24.25±12.68dB. In the cartilage group, the preoperative ABG was 35.68±12.94dB, and postoperative ABG was 26.11±12.87dB. The anatomical success rate in the cartilage group was significantly better than that for the fascia group (p<0.01). There was no statistically significant difference in functional outcomes between the fascia and cartilage groups (p>0.05). The average thickness of tragal cartilage in the pediatric population was 0.693±0.094mm in males and 0.687±0.058mm in females.ConclusionsOur data suggest that the anatomical success rate for a cartilage tympanoplasty was higher than that for a fascia tympanoplasty. Functional results with cartilage were not different than those with fascia, even though we did not thin the tragal cartilage. However, further studies should focus on the interaction between the thickness of the tragal cartilage and the tympanoplasty success rate.



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