The wheel-shaped composite cartilage graft for type 1 tympanoplasty:
Comparison with palisade and island cartilage graft.
Abstract
Objectives: This study aims to compare the graft success and hearing
results of the palisade and island cartilage graft, with a new
wheel-shaped composite cartilage graft for type 1 tympanoplasty. Design:
The study was designed retrospectively. Setting: The study was conducted
at Katip Celebi University, Ataturk Training and Research Hospital,
Otolaryngology-Head & Neck Surgery Clinic. Participants: Only patients
with conductive hearing loss and simple pars tensa perforation of the
tympanic membrane were included in the study. Main outcome measures:
Pure tone average (PTA), air-bone gap gain (ABG), word recognition score
(WRS), ABG closure and grafts success were compared between the graft
groups. Results: Records of 111 patients were analyzed. The graft
success rate was 89.7% for palisade cartilage graft (PCG, n= 39),
86.1% for island cartilage graft (ICG, n=36), and 97.2% for
wheel-shaped composite cartilage graft (WsCCG, n= 36) (p=0.244). Average
postoperative PTA and ABG values were significantly affected by the
cartilage graft type, but WRS was not affected. (p = 0.005, 0.019,
0.306, respectively, One Way-Anova test). Post-Hoc LSD test showed a
statistically significant decrease in PTA and ABG averages for WsCCG
group compared to the ICG group (p= 0.004; CI%95= 15.1-2.2 dB and p=
0.023; CI%95= 8.2-0.4 dB, respectively). Postoperative PTA and ABG
averages for WsCCG and PCG groups were similar (p= 0.069 and p=0.053,
respectively). In addition, while there were 2 (5.1%) retractions in
the PCG group and 1 (2.7%)in the ICG group, there was no retraction in
the WsCCG group. Conclusion: The WsCCG provided comparable results with
classical reliable graft techniques (PCG and ICG) and may recommend as a
more suitable graft due to hearing results and resistance against
retraction.