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<p>Chronic tympanic membrane (TM) perforations can lead to hearing loss and recurrent ear infections. Tympanoplasty aims to restore TM integrity and improve auditory function. While temporalis fascia is a commonly used grafting material, cartilage may offer superior mechanical stability, particularly in large or anterior perforations. To evaluate and compare the anatomical and functional outcomes of endoscopic tympanoplasty using a single-layer temporalis fascia graft versus a double-layer graft combining tragal cartilage and temporalis fascia in patients with central TM perforations. This prospective comparative study included 50 adult patients with safe-type chronic suppurative otitis media and central TM perforations. Patients were randomly assigned to two groups: Group A (n = 25) underwent tympanoplasty with temporalis fascia alone, while Group B (n = 25) received a double-layer graft of tragal cartilage and temporalis fascia. All surgeries were performed endoscopically. Graft uptake and hearing outcomes were assessed over a 3-month follow-up period using otoscopy and pure-tone audiometry. At 3&#xa0;months postoperatively, graft uptake was significantly higher in Group B (92%) compared to Group A (60%) (<i>p</i> &lt; 0.05). Both groups demonstrated hearing improvement. The mean reduction in air-bone gap (ABG) was 13.48 ± 3.23&#xa0;dB in Group A and 12.09 ± 2.37&#xa0;dB in Group B, with the difference approaching statistical significance (<i>p</i> = 0.05). Postoperative complications, including re-perforation and graft medialization, were more frequent in the single-layer group. Endoscopic double-layer tympanoplasty using tragal cartilage and temporalis fascia provides superior anatomical outcomes and comparable auditory improvement compared to single-layer fascia grafting. This technique is especially beneficial for large, subtotal, or anterior perforations.</p>

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Endoscopic Tympanoplasty: Comparison Between Double Grafting and Single Grafting Technique

  • 期刊论文

  • 发表日期：

    2025年11月24日

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  • Ajaiy Muthu,
  • Preethi Ravikumar

摘要

Chronic tympanic membrane (TM) perforations can lead to hearing loss and recurrent ear infections. Tympanoplasty aims to restore TM integrity and improve auditory function. While temporalis fascia is a commonly used grafting material, cartilage may offer superior mechanical stability, particularly in large or anterior perforations. To evaluate and compare the anatomical and functional outcomes of endoscopic tympanoplasty using a single-layer temporalis fascia graft versus a double-layer graft combining tragal cartilage and temporalis fascia in patients with central TM perforations. This prospective comparative study included 50 adult patients with safe-type chronic suppurative otitis media and central TM perforations. Patients were randomly assigned to two groups: Group A (n = 25) underwent tympanoplasty with temporalis fascia alone, while Group B (n = 25) received a double-layer graft of tragal cartilage and temporalis fascia. All surgeries were performed endoscopically. Graft uptake and hearing outcomes were assessed over a 3-month follow-up period using otoscopy and pure-tone audiometry. At 3 months postoperatively, graft uptake was significantly higher in Group B (92%) compared to Group A (60%) (p < 0.05). Both groups demonstrated hearing improvement. The mean reduction in air-bone gap (ABG) was 13.48 ± 3.23 dB in Group A and 12.09 ± 2.37 dB in Group B, with the difference approaching statistical significance (p = 0.05). Postoperative complications, including re-perforation and graft medialization, were more frequent in the single-layer group. Endoscopic double-layer tympanoplasty using tragal cartilage and temporalis fascia provides superior anatomical outcomes and comparable auditory improvement compared to single-layer fascia grafting. This technique is especially beneficial for large, subtotal, or anterior perforations.