Comparison of Graft Uptake and Post Operative Hearing between Cartilage Rim Augmented Fascia and Temporalis Fascia Tympanoplasty

To compare the graft uptake and postoperative hearing between cartilage rim augmented fascia and temporalis fascia type I tympanoplasty. Materials and methods: This prospective, longitudinal, comparative, randomized and interventional study was conducted at Department of ENT, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu for a period of 16 months amongst fifty two patients of age 15 years and above with the diagnosis of chronic otitis media mucosal with high risk perforation and cases of revision type I tympanoplasty with pure conductive or mixed hearing loss divided equally into cartilage rim augmented fascia tympanoplasty group and temporalis fascia tympanoplasty group. Graft uptake and hearing results were assessed after three months of surgery and compared. A postoperative residual air-bone gap of 20 dB or less was considered a successful hearing outcome. Results: Graft uptake rate in cartilage rim augmented fascia group was 91.67% (22/24) and in temporalis fascia group was 96% (24/25) with no statistically significant difference in the graft uptake rate (p=0.609) between the two groups. The mean pre and postoperative air-bone gaps in the cartilage rim augmented fascia group were 29.68±9.66 dB and 12.56±5.10 dB and in the temporalis fascia group were 28.02±8.21 dB and 12.5±5.37 dB respectively. There was no statistically significant difference in successful hearing results between the two groups (p=1.00). Conclusion: The graft uptake rate and hearing results of cartilage rim augmented fascia tympanoplasty are comparable to those of temporalis fascia tympanoplasty. Hence, cartilage rim augmented fascia type I tympanoplasty can be an alternative for the repair of high-risk perforations.