title: Comparison of different grafting techniques in type I tympanoplasty in cases of significant middle ear granulation.
abstract: OBJECTIVE
  To assess anatomical and hearing results after different reconstruction methods of tympanic membrane in cases of severe middle ear granulation.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Secondary care medical center.
  
  
  METHODS
  Forty patients with severe middle ear granulation were included.
  
  
  METHODS
  Canal wall-up mastoidectomy with Type I tympanoplasty. Temporalis fascia was used in 22 patients, cartilage island flap was used in 10 patients, and cartilage palisade was used in 8 patients.
  
  
  METHODS
  Graft take, air-bone gap, and air-bone gap closure ratio of 50% or more.
  
  
  RESULTS
  In the fascia group, the graft take rate was 91%, whereas the graft take rate for the cartilage island group and the cartilage palisades group was 100% (p = 0.617). Mean ± SD preoperative air-bone gaps for the fascia, island flap, and cartilage palisades were 30 ± 9.4, 26 ± 11.7, and 25 ± 10.8 dB, respectively. Postoperative air-bone gaps were 17 ± 10.2, 14 ± 8.4, and 19 ± 7.5 dB, respectively, in the same order. The cartilage palisades group failed to show statistically significant difference between preoperative and postoperative air-bone gaps (p = 0.195). Air-bone gap closure ratio of 50% or more was found in 11 cases (50%) of the fascia group, in 5 cases (50%) of the island flap group, and in 1 case (13%) of the cartilage palisades group.
  
  
  CONCLUSIONS
  Cartilage palisades showed reliable graft take but slightly poor hearing results. Thus, fascia or cartilage island grafting might be better for tympanoplasty in cases of severe middle ear granulation tissue.
authors.affiliation: Department of Otorhinolaryngology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
authors.forename: Jong Cheol
authors.initials: JC
authors.lastname: Lee
authors.forename: Seong Rok
authors.initials: SR
authors.lastname: Lee
authors.forename: Jung Kwon
authors.initials: JK
authors.lastname: Nam
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Joong Keun
authors.initials: JK
authors.lastname: Kwon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D006097:Granulation Tissue / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*; D014433:Tympanoplasty / Q000379:methods*; D055815:Young Adult