Comparison of Clinical Outcomes in Bilateral Simultaneous Myringoplasty: Cartilage vs. Temporalis Fascia Graft for Graft Uptake
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Abstract
Background: Chronic Suppurative Otitis Media (CSOM) is a prevalent condition characterized by persistent ear discharge and tympanic membrane perforation, leading to significant hearing loss if left untreated. Surgical intervention through myringoplasty aims to repair the tympanic membrane. This study compares the clinical outcomes of bilateral simultaneous myringoplasty using cartilage versus temporalis fascia grafts.
Objective: To evaluate and compare the effectiveness of cartilage and temporalis fascia grafts in terms of graft uptake, hearing improvement, and complication rates in patients with CSOM.
Methods: A prospective study was conducted from January 2024 to July 2024 at Sree Balaji Medical College and Hospital, Chennai, involving 50 patients with bilateral CSOM. Patients underwent bilateral simultaneous myringoplasty under general anesthesia, with one ear receiving a cartilage graft and the other a temporalis fascia graft. Clinical outcomes were assessed using preoperative and postoperative pure tone audiometry (PTA) scores, graft healing rates, and postoperative air-bone gap closure. Data were analyzed using R software, with a p-value < 0.05 considered statistically significant.
Results: Cartilage grafts demonstrated superior clinical outcomes compared to temporalis fascia grafts. A greater reduction in PTA scores was observed with cartilage grafts (12.7 dB vs. 9.1 dB, p < 0.001). Postoperative PTA outcomes also favored cartilage grafts (24.5 dB vs. 29.8 dB, p < 0.001). Cartilage grafts achieved higher healing rates (72% vs. 50%, p = 0.024) and a more favorable postoperative air-bone gap (52% vs. 36%, p = 0.032).
Conclusion: Cartilage grafts provide better audiological and clinical outcomes than temporalis fascia grafts in bilateral simultaneous myringoplasty for CSOM. These findings support the use of cartilage grafts, especially in cases with large or complex tympanic membrane perforations. Further research should explore the underlying mechanisms and broader clinical applications of cartilage grafts in tympanoplasty.