COMPARISON BETWEEN TRAGAL CARTILAGE WITH PERICHONDRIUM AND TEMPORALIS FASCIA GRAFT IN TYPE 1TYMPANOPLASTY

Abstract

Objective: To compare the efficacy of Tragal Cartilage Tympanoplasty (TC) and conventional Temporalis Fascia (TF) Tympanoplasty in terms of graft uptake and hearing outcomes.

Methodology: This cross-sectional study was conducted in the Department of Otorhinolaryngology at Fazaia Medical College (FMC), PAF Hospital, Islamabad, from December 2020 to January 2025. A total of 90 patients with mucosal-type chronic suppurative otitis media (CSOM) were enrolled and categorized into two groups: Group A (46 patients undergoing Tympanoplasty with TF graft) and Group B (44 patients undergoing tympanoplasty with TC and perichondrium graft). All patients of CSOM who met the inclusion criteria underwent comprehensive preoperative assessments, including otoscopy, tuning fork tests, Valsalva maneuver, fistula test, and facial nerve integrity. Pure tone audiometry (PTA) was performed to measure hearing levels. Type I tympanoplasty, using TF for Group A and TC with perichondrium for Group B. Postoperative outcomes were evaluated, with hearing thresholds via PTA at 3 and 6 months. Data were analyzed using SPSS version 22, with statistical significance defined as a p-value <0.05.

Results: We evaluated 90 patients; 46 in Group A and 44 in Group B. Preoperative mean hearing loss was approximately 30 dB in Group A and 35 dB in Group B. Type I Tympanoplasty was performed either microscopically or endoscopically. Success rates of graft uptake was 95.65% for Group A and 95.45% for Group B, indicating no statistical significance. However, hearing improvement, was greater in Group B (20 dB) compared to Group A. Statistically significant difference was observed (P<0.05).

Conclusion: TC with perichondrium is more effective in achieving 2:20 dB air-bone gap (AB gap) closure compared to TF.