COMPARISON OF TEMPORALIS FASCIA VERSUS FULL-THICKNESS CARTILAGE GRAFTS IN TYPE 1 TYMPANOPLASTIES

Abstract

Objective: 

To compare the anatomical and functional outcomes of full-thickness tragal cartilage grafts versus temporalis fascia grafts in patients undergoing type 1 tympanoplasty.

Methods: 

A randomized controlled trial was conducted with 110 patients, randomly allocated into two groups of 55 each. Group A received temporalis fascia grafts, and Group B received full-thickness tragal cartilage grafts. Anatomical success (graft take rate) and functional success (post-operative air-bone gap ≤20 dB) were assessed at six-month follow-up using otoscopy and pure-tone audiometry. Statistical analysis was performed using SPSS version 23.

Results: 

The cartilage graft group demonstrated a significantly higher anatomical success rate (89.1%) compared to the fascia group (69.1%) (p=0.011). Both groups showed significant hearing improvement, with no statistically significant difference in post-operative air-bone gaps (p=0.331) or in the proportion of patients achieving a functional success (ABG ≤20 dB) (p=0.270). Subgroup analyses based on age, duration of chronic suppurative otitis media (CSOM), and gender revealed no significant differences in outcomes.

Conclusion: 

Full-thickness tragal cartilage grafts provide superior anatomical reliability compared to temporalis fascia in type 1 tympanoplasty, with a significantly higher graft take rate. However, both graft materials yield comparable and satisfactory functional hearing outcomes. Cartilage should be considered a preferable grafting material, especially in high-risk or revision cases, due to its enhanced structural durability.