Revision Tympanoplasty Using Scar Tissue Graft

Objective: To evaluate the success rate of subcutaneous postsurgical scar tissue as graft material for revision tympanoplasty operations.

Study Design: Retrospective case review.

Setting: Tertiary referral center.

Patients: Thirty-five patients who underwent revision tympanoplasty with or without mastoidectomy procedures and 36 patients undergoing primary operations who had all the data necessary for the study and a minimum follow-up of 6 months. The mean follow-up period was 12 months (range, 6-18 mo). Mean age, perforation size, cholesteatoma presence, time required for harvesting, and adjunctive mastoidectomies were similar between the two groups.

Intervention: The patients undergoing revision tympanoplasty had graft material harvested from the subcutaneous scar tissue. In the control group, temporalis fascia graft was used as graft tissue.

Main Outcome Measures: The rate of perforation closure and postoperative hearing change was measured.

Results: In the scar tissue tympanoplasty group, 32 of 35 patients (91%) had successful closure of the tympanic membrane perforation, whereas in the control group, the success rate was 92% (p > 0.05). Mean postoperative pure-tone average improvement was 21 dB in the scar tissue tympanoplasty group and 18 dB in the control group (p > 0.05).

Conclusion: Subcutaneous scar tissue is as successful in perforation closure and hearing improvement as temporalis fascia graft. The use of subcutaneous scar tissue graft is advantageous to other graft materials used in revision tympanoplasty operations in that it can be harvested through the same incision, does not add to the operative time, and does not carry the cost or risk of acellular dermis.