Abstract
Various grafting materials and different ways of positioning have been described for
tympanic membrane (TM) reconstruction. However, there are few clinical trials comparing
cartilage and periosteal grafts.
Aims: A comparison between underlay periosteal grafting (UPG) and inlay cartilage
grafting (ICG) of TM.
Material and Methods: A retrospective controlled trial. Group A, included 88 patients
underwent UPG. Group B, included 61 patients subjected to ICG.
Assessment included: Mean Air Bone Gap (ABG), operative time and graft take. Data was
summarized using mean and standard deviation in quantitative data and using frequency
(count) and relative frequency (percentage) for categorical data. Comparisons between
quantitative variables were done using unpaired t test. For comparing categorical data, Chi
square (2
) test was performed.
Results: Graft healing was statistically insignificant between both groups, with group A
cases showing 93% complete graft healing and 92% in group B (P value= 0.8). However,
group A mean difference ABG was statistically significant ( -11 dB ± 5 SD) when compared
to group B (- 9 dB ± 7 SD) with P value= 0.01. Operative time comparison was statistically
significant with 33 minutes ± 5 SD in group A, while in group B was 19 minutes ± 3 SD
(P<0.001).
Conclusion: Underlay periosteal and inlay cartilage grafts show high rates of graft take,
with better hearing results using underlay periosteal grafts but shorter operative time with
inlay cartilage grafts. Long term follow up is recommended in future studies.