gms | German Medical Science

Introduction: Retraction or perforation after reconstruction of the eardrum are well known problems in tympanoplasty. Different techniques and materials, including cartilage and temporalis fascia have been used in an attempt to prevent these problems.

Today cartilage is more and more often used in middle ear surgery. It is therefore interesting to compare the outcomes in the short and long term with fascia grafting, which is still the most commonly used material.

Methods: Between January 2002 and July 2009 a total of 182 patients aged 18 to 55 underwent surgery for noncholesteatomatous diseases of middle ear. The eardrum was reconstructed using cartilage palisades or cartilage composite grafts in 84 cases and temporalis fascia in 98 cases. The choice between the cartilage in both forms and fascia graft material was at random. Hearing was evaluated by two methods: absolute hearing( pure tone average ) and air-bone gap. For absolute hearing and air-bone gap, an average of thresholds at 500, 1000, 2000 and 4000 Hz was calculated. Hearing results were reported at 12 and 30 months.

Results: All patients in the cartilage group attended the follow-up examinations for at least two years. In the fascia group there were 5 patients that did not attend the follow-up examinations. In the cartilage group the mean follow up period was 31 months and 35 months in the fascia group. We present and discuss our results regarding residual perforations, retractions and hearing.

Conclusion: The results regarding the residual perforations and hearing are quite the same no matter the material used for the reconstruction. In poor ventilated ears cartilage seems to be a better option for eardrum reconstruction, but it requires a longer follow-up period.