Study evaluating the effectiveness of composite cartilage grafts vs temporalis fascia graft in tympanoplasty - Randomised controlled trial

Tympanoplasty, a surgical procedure aimed at repairing the tympanic membrane (eardrum), has been a cornerstone in the management of various middle ear pathologies, including chronic otitis media and tympanic membrane perforations. The success of tympanoplasty largely depends on the choice of graft material utilized for the reconstruction of the tympanic membrane. Among the commonly employed graft materials, temporalis fascia and composite cartilage-perichondrium grafts have gained significant attention due to their unique properties and favourable outcomes reported in clinical practice.

Temporalis fascia, harvested from the temporalis muscle, has been widely utilised in tympanoplasty for decades. Its pliability, availability, and low immunogenicity make it a popular choice among otologic surgeons. However, concerns regarding its long-term durability and propensity for retraction have led to the exploration of alternative graft materials.

In recent years, one-piece composite cartilage-perichondrium grafts have emerged as a promising alternative to temporalis fascia. Comprising both cartilage and perichondrium layers harvested from the tragus or conchal bowl, these grafts offer structural support, stability, and reduced risk of retraction. Moreover, they possess inherent vascularization, potentially promoting better graft incorporation and long-term outcomes.

Despite the growing body of literature comparing these graft materials, there remains a lack of consensus regarding the optimal choice for tympanoplasty. While some studies have demonstrated superior outcomes with composite cartilage-perichondrium grafts, others have reported comparable success rates between the two materials. Therefore, a comprehensive comparative analysis is warranted to elucidate the advantages and limitations of temporalis fascia and composite cartilage-perichondrium grafts in tympanoplasty.

This study is a comparative analysis of types of grafts used in comparison with the tympanic membrane perforation and post operative assessment with audiology and otoendoscopic findings and hence conclude on graft of choice for tympanoplasty in a coastal region.