A Comparative study between Sliced Cartilage versus Temporalis Fascia in Type I Tympanoplasty

This is a prospective study between sliced cartilage versus temporalis fascia in type 1 tympanoplasty conducted on 50 patients of Chronic otitis media mucosal type conducted in Thanjavur medical college in our ENT department. Patients are grouped randomly between temporalis fascia and cartilage group. The graft is placed by underlay technique. Postoperative results measured in terms of graft take up (anatomical success) and hearing improvement (functional success) are evaluated at 3 and 6 months. Each patient preoperatively underwent otoendoscopic examination and pure tone audiometry, after procuring the consent from them. Patients are grouped randomly between temporalis fascia and cartilage group. Patient underwent Mastoidectomy with type 1 tympanoplasty for active disease and Myringoplasty for inactive cases. Postoperatively patients were followed up and results in terms of graft take up (anatomical success) and hearing improvement (functional success) assessed by pure tone audiometry and impedance done at 3rd month. The temporalis fascia group had a hearing improvement of 9.04 dB and sliced tragal cartilage group had 10.3 dB. There was statistically significant difference in hearing postoperatively in both groups but there was no statistically significant difference between the two groups. In the temporalis fascia group which had 25 patients 20 (80%) had good graft take up. In the sliced cartilage group of 25 patients 22 (88%) had positive results. The difference in graft uptake between the 2 groups was found to be statistically insignificant. Sliced cartilage is a reliable and good auto-graft in tympanoplasty, which can give good hearing improvement and has good graft take-up, which is comparable with that of temporalis fascia. Though the results were statistically insignificant but clinically sliced cartilage found to be better graft than fascia in tympanoplasties