Hearing results after primary cartilage tympanoplasty with island technique.
OBJECTIVE
Because of its rigid quality, cartilage is the grafting material of choice in advanced pathologies, such as adhesive processes or recurrent perforations. However, the use of such a rigid material in tympanic membrane reconstruction causes controversies as to the audiologic aspect. The purpose of this study was to assess overall and frequency-specific hearing results after primary cartilage tympanoplasty with island technique in comparison to the hearing results after primary tympanoplasty with temporalis muscle fascia.


METHODS
This study was a retrospective review of selected cases between 1999 and 2002. Primary cases with intact ossicular chain, normal middle ear mucosa, and subtotal perforation of the tympanic membrane were included in the study. Fifteen patients were in the cartilage group, whereas 10 patients were in the fascia group. Preoperative and postoperative air-bone gaps at the frequencies of 0.5, 1, 2, and 4 kHz were compared.


RESULTS
Both groups were statistically similar on the aspect of the severity of middle ear pathology and the preoperative hearing levels. Mean postoperative gains in air-bone gap were 11.9 dB for the cartilage group and 11.5 dB for the fascia group. There were no statistically significant differences in the postoperative frequency-specific gains in air-bone gap between the 2 groups.


CONCLUSIONS
Although cartilage is the ideal grafting material in problem cases, its comparable acoustic properties, especially in the form of cartilage island, to those of fascia will allow a more liberal application in less severe cases, in which functional outcome is more essential.
Kirazli
Tayfun
T
Department of Otorhinolaryngology, Medical School of Ege University, Turkey.
Bilgen
Cem
C
Midilli
Rasit
R
Ogüt
Fatih
F
D000293:Adolescent; D000328:Adult; D001299:Audiometry; D002356:Cartilage / Q000637:transplantation*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*