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Purpose <p>To evaluate the efficacy of the Double-C cartilaginous scaffold technique in the transcanal repair of large anterior-predominant tympanic membrane perforations.</p> Methods <p>This single-arm prospective study included 37 patients with large anterior-predominant tympanic membrane perforations, an intact ossicular chain, and no cholesteatoma, who underwent transcanal microscopic myringoplasty using a standardized double-layered, C-shaped tragal cartilage scaffold with an underlay perichondrial layer. Postoperative outcomes assessed were graft uptake, air–bone gap (ABG) closure, and complications over a minimum follow-up of six months.</p> Results <p>Graft uptake was achieved in 34 patients (91.9%), with no blunting, lateralization, cartilage extrusion, or canal stenosis observed. The mean preoperative ABG was 33.1 ± 3.3 dB, which improved significantly to 13.2 ± 4.5 dB at 6 months postoperatively (<i>p</i> &lt; 0.001), with a mean hearing gain of 19.9 ± 4.4 dB. No major complications occurred.</p> Conclusion <p>The Double-C cartilaginous scaffold technique effectively addresses the challenge of inadequate anterior graft support, providing reliable anatomical closure and significant functional hearing improvement in patients with large anterior-predominant tympanic membrane perforations.</p>

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The Double-C cartilaginous scaffold: a novel technique for transcanal repair of large anterior-predominant tympanic membrane perforations

  • 期刊论文

  • 发表日期：

    2026年4月29日

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  • Mahmoud Reda,
  • Malak Gaber

摘要

Purpose

To evaluate the efficacy of the Double-C cartilaginous scaffold technique in the transcanal repair of large anterior-predominant tympanic membrane perforations.

Methods

This single-arm prospective study included 37 patients with large anterior-predominant tympanic membrane perforations, an intact ossicular chain, and no cholesteatoma, who underwent transcanal microscopic myringoplasty using a standardized double-layered, C-shaped tragal cartilage scaffold with an underlay perichondrial layer. Postoperative outcomes assessed were graft uptake, air–bone gap (ABG) closure, and complications over a minimum follow-up of six months.

Results

Graft uptake was achieved in 34 patients (91.9%), with no blunting, lateralization, cartilage extrusion, or canal stenosis observed. The mean preoperative ABG was 33.1 ± 3.3 dB, which improved significantly to 13.2 ± 4.5 dB at 6 months postoperatively (p < 0.001), with a mean hearing gain of 19.9 ± 4.4 dB. No major complications occurred.

Conclusion

The Double-C cartilaginous scaffold technique effectively addresses the challenge of inadequate anterior graft support, providing reliable anatomical closure and significant functional hearing improvement in patients with large anterior-predominant tympanic membrane perforations.