Article Type

Original Study


Although the temporalis fascia has been widely used since 1957 as a graft in tympanoplasty, the utility of cartilage in middle ear reconstructive surgery is becoming apparent. Autogenous cartilage contributes min­imally to an inflammatory tissue reac­tion and is incorporated in the middle layer of the tympanic membrane (TM) giving a firm scaffolding and resis­tance for infection during the healing period. Via a transcanal approach without raising a posterior tympanomeatal flap and after freshening of the edge of the TM perforation , a disc of tragal cartilage-perichondrium com­posite graft was applied medially to repair the defect in 64 patients . They all had dry central perforation of the small - to - medium sized category with conductive hearing loss no greater than 35 dB in any frequency at the time of surgery. Anatomically, the success rate in terms of" graft take " was 95.3 % and functionally the postoperative air-bone gap was reduced to less than 10 dB in 87.5 % and to less than 20dB in 98% at the end of the follow-up period (longest follow-up, 30 month; shortest follow-up, 6 month; average follow -up, 16 months). These results demonstrate that the described technique is efficient and effective to close a subgroup of non- marginal TM perforations. The post - operative patient comfort and the cost-effectiveness of the tech­nique show additional advantage. Tragal cartilage was found to be an excellent graft material and its use has made a significant improvement in the TM reconstruction procedure. Cartilage should be used more widely in tympanoplasty.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.