Comparative study of simple myringoplasty with three different kinds of autologous substitutes

OBJECTIVE To evaluate the therapeutic efficacy of simple myringoplasty with three different kinds of autologous substitutes. METHODS The patients (107 ears)with tympanic membrane perforation underwent myringoplasty using autologous temporal fascia, perichondrium or tragus cartilage-perichondrium compound. The postoperative healing effects and hearing levels of all cases were studied. RESULTS In healingeffects and hearing levels of the patients with small tympanic membrane perforation, there was no difference among the three kinds of autologous substitutes. Cartilage-perichondrium compound was much better for the patients with large tympanic membrane perforation in primary healing than temporalis fascia and perichondrium(P0.05). At one year after surgery, the tympanic membrane repaired with temporalis fascia or perichondrium perforated again or appeared invaginated and adhesive in some patients. Early hearing improvement of temporalis fascia and perichondrium group was better than that of cartilage-perichondrium compound, but no difference at one year after surgery. CONCLUSION ① All of the three kinds of autologous substitutes are suitable for the myringoplasty of the patients with small tympanic membrane perforation. ② Cartilage-perichondrium compound is much better than temporalis fascia and perichondrium for the patients with large tympanic membrane perforation.