The Wheel-shaped Composite Cartilage Graft (WsCCG) and Temporalis Fascia for Type 1 Tympanoplasty: a Prospective, Randomized Study

Overview

Journal Eur Arch Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2018 Oct 15

PMID 30317384

Citations 4

Authors

Ejder Ciger

Mustafa Koray Balci

Akif Islek

Kazim Onal

Affiliations

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Abstract

Objectives: To compare the anatomical and functional outcomes of two different grafts which are used for the reconstruction of subtotal or total tympanic membrane perforations: the wheel-shaped composite cartilage graft (WsCCG) and temporalis fascia (TF).

Methods: Ninety patients (94 ears) who underwent type 1 tympanoplasty for non-complicated chronic otitis media between March 2014 and June 2016 in a tertiary referral center were included in a randomized, controlled, prospective clinical trial. Tympanic membranes were reconstructed with the WsCCG or TF.

Results: Outcomes of 91 surgeries performed on 87 adults (> 18 years of age) were evaluated in the study. Forty-three patients (44 ears) were included in the WsCCG group; 44 patients (47 ears) were included in the TF group. The mean post-operative follow-up was 14.9 months for the WsCCG group and 15.1 months for the TF group. There was no statistically significant difference in post-operative pure tone average (PTA) (p = 0.19), air-bone gap (ABG) (p = 0.64), PTA gain (p = 0.82) and ABG closure (p = 0.89) values between two groups. Graft success rates at 6 months after surgery were 82.9% (39/47) and 97.7% (43/44) for TF and WsCCG, respectively. At the first year, success rates were 85.1% (40/47) for TF and 97.7% (43/44) for WsCCG. A statistically significant difference was observed in graft success rates between two groups (p = 0.039).

Conclusions: Both TF and WsCCG lead to satisfactory functional results, but the WsCCG clearly leads to superior anatomical outcomes with a graft success rate of 97.7%. The WsCCG is a suitable graft for subtotal or total tympanic membrane perforations and has the advantages of being a one-piece, flexible, composite, and physically resistant graft.

Citing Articles

Endoscopic Over Under Cartilage Tympanoplasty Is Not Inferior to Underlay Cartilage Tympanoplasty.

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To detach or not to detach the umbo in type I tympanoplasty: functional results.

Lotto C, Fink R, Stricker D, Fernandez I, Beckmann S, Presutti L Eur Arch Otorhinolaryngol. 2023; 281(6):2871-2876.

PMID: 38105363 DOI: 10.1007/s00405-023-08370-6.

Comparison of temporalis muscle fascia and cartilage grafts for primary type 1 tympanoplasty: a meta-analysis of randomized controlled trials.

Lajdam G, Alahmadi R, Alhakami M, Ghaddaf A, Abdulhamid A, Alahmadi A Eur Arch Otorhinolaryngol. 2023; 280(12):5153-5165.

PMID: 37540270 DOI: 10.1007/s00405-023-08170-y.

The Wheel-Shaped Composite Cartilage Graft for Type 1 Tympanoplasty: Comparison with Palisade and Island Cartilage Graft.

Ciger E, Islek A, Yazir M Indian J Otolaryngol Head Neck Surg. 2023; 74(Suppl 3):3806-3812.

PMID: 36742525 PMC: 9895456. DOI: 10.1007/s12070-021-02624-7.

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