Anatomical and Audiological Outcomes of Cartilage Tympanoplasty
30 September 2019 (online)
Aim To evaluate anatomical and audiological outcomes of cartilage tympanoplasty.
Materials and Methods A prospective, observational study (pilot study) was undertaken at a tertiary referral institute in North Karnataka. The study included 30 patients with chronic otitis media requiring tympanoplasty. Tympanic membrane reconstruction was done using 0.5 mm thickness conchal cartilage. Patients with tubotympanic and atticoantral disease were included in the study. Patients were assessed at first and third postoperative months for graft uptake and hearing evaluation was conducted using pure tone audiometry for the frequencies 500 Hz, 1 K, 2 K, and 4 K.
Results A successful outcome was defined as complete healing of graft without retraction and lateralization for minimum 3 months of follow-up. Twenty-eight patients had fully epithelialized, completely healed grafts postoperatively at 1 month. Two cases had small residual perforation which healed on chemical cauterization on subsequent follow-up. The mean air–bone gap considerably reduced from 30.4 ± 4 dB preoperatively to 16.1 ± 5 dB postoperatively.
Conclusion Tympanic membrane reconstruction using 0.5 mm thickness cartilage provides good anatomical and audiological results with significant improvement in hearing, especially in subtotal perforation, where healing of tympanic membrane has much poorer prognosis irrespective of surgical technique used.
Clinical Significance In India, temporalis fascia is the widely used graft material despite the proven publications, reiterating the efficacy of cartilage tympanoplasty. The present paper highlights the good anatomical and audiological outcomes.