Outcomes of Tympanoplasty with an Autologous Two-Piece Perichondrium-Cartilage Graft in a Tertiary Care Setting

TL;DR

This study shows that a specific surgical technique for repairing ear perforations is effective in both children and adults, with success rates over 80%.

Contribution

The study introduces a two-piece perichondrium-cartilage graft for tympanoplasty and demonstrates its effectiveness across pediatric and adult populations.

Findings

93.2% of patients achieved successful tympanic membrane closure.

Combined success rate (TM closure and ABG < 20 dBHL) was 86.3%.

Larger perforations (>50%) had significantly lower success rates (55.6%).

Abstract

Background/Objectives: This study evaluates the anatomical and functional outcomes of type 1 tympanoplasty using an autologous two-piece perichondrium-cartilage (CP) graft in pediatric and adult patients with tympanic membrane (TM) perforations. Methods: A retrospective review of 74 patients (59 children, 15 adults) undergoing type 1 tympanoplasty with CP by a single surgeon (IF) was conducted. Preoperative and postoperative audiological outcomes, perforation size, prognostic factors, and complications were analyzed. Success was defined as an intact TM and an air–bone gap (ABG) < 20 dBHL at 12 months postoperatively. Results: TM closure was achieved in 93.2% of patients, with 93.1% attaining an ABG < 20 dBHL. The combined success rate was 86.3%, with no significant differences between children and adults. Larger perforations (>50%) had significantly lower closure rates (55.6% vs. >97%, p < 0.002). Children who underwent prior adenoidectomy had significantly higher success rates (p = 0.04). Conclusions: Tympanoplasty with a CP graft provides high success rates in both children and adults. The procedure can be performed from age five, considering patient cooperation. In children, simultaneous adenoidectomy is recommended if significant adenoid hypertrophy is present to optimize outcomes. Larger perforations were associated with reduced success, while age had no significant impact.

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