Perichondrium/Cartilage Island Flap and Temporalis Muscle Fascia in Type I Tympanoplasty

Objective: To compare the functional results of primary type I tympanoplasty performed with temporalis muscle fascia and a perichondrium/cartilage island flap. Design: Retrospective chart review. Setting: Research and training hospital. Methods: The records of patients who underwent type I tympanoplasty between 2006 and 2009 were reviewed. This study aimed to comprise a homogeneous group of patients to make the comparisons as accurate as possible. For this purpose, primary tympanoplasty cases with an intact ossicular chain, a dry ear for a period of at least 1 month, and normal middle ear mucosa were included in the study. Finally, 48 patients in the fascia group and 44 patients in the cartilage group were reviewed for graft take, pre- and postoperative air-bone gaps, and pure-tone averages. Main Outcome Measures: The functional results of cartilage and fascia in a homogeneous group of patients were analyzed. Results: The graft take rate was 89.6% for the fascia group and 93.2% for the cartilage group. Significant recovery was found in the postoperative pure-tone averages and air-bone gaps compared to preoperative thresholds in both the fascia and the cartilage group. Although there was no statistically significant difference between the two graft materials for graft take rates and mean pure-tone averages, cartilage allowed us to achieve slightly better functional results than fascia grafting. Furthermore, the difference between the two graft materials for air-bone gaps was significant postoperatively in favour of the cartilage. Conclusions: Although one might expect some conductive hearing loss with cartilage owing to its thickness and rigidity, the hearing results of both methods are acceptable, with a slight statistical favouring of cartilage over fascia for air-bone gap measures.