Cartilage graft in type I tympanoplasty:: audiological and otological outcome

The aim of this study is to evaluate anatomical and audiological results of cartilage tympanoplasty compared to fascia tympanoplasty in the reconstruction of tympanic membrane perforations. We carry a retrospective study about 380 patients operated in our department between 1998 and 2005. Patients were classified into two groups: 90 (23.6%) undergo cartilage tympanoplasty and 290 (76.4%) fascia tympanoplasty. In each group, we calculated the average of pre and postoperative air bone gap (ABG) and the average air conduction gain (ACG) at 250-4,000 Hz. The surgical technique is explained in detail. We detail and analyze the audiological and anatomical results in each group. Successful closure of the tympanic membrane perforation was achieved in 97% of the cartilage group as compared to 94% of the fascia group. The average ACG was 21 +/- 11 dB in cartilage group and 20 +/- 22 dB in fascia group. With an average follow-up of 2 years, residual perforation was observed in 2.2% in cartilage group. Reperforation of fascia graft and retraction were noted in 2.1 and 1%, respectively. The authors show the great reliability of cartilage tympanoplasty to close tympanic membrane perforations. We recommend using cartilage as a first choice, especially in stable or evolutive chronic otitis media, and in recurrent perforation of the tympanic membrane.