Areolar temporalis fascia: a reliable graft for tympanoplasty

This study examines the success rate of areolar temporalis fascia (fool's fascia) as a graft material for tympanoplasty.

This study is a retrospective review of surgical cases.

This study was conducted at Kaiser Permanente Medical Center, San Diego, a tertiary referral center for otologic surgery within Southern California Permanente Medical Group.

Four hundred six patients having undergone tympanoplasty (with and without mastoidectomy) from September 1992 to December 1997 were observed. Medial graft (underlay) techniques were used in all cases, including total drum replacement procedures. Sixty-three percent (256/406) of the cases were revision surgeries. Seventy-three percent (296/406) of the cases were for total drum replacement. In 342 (84%) cases, areolar temporalis fascia was used as the graft material.

Successful tympanic membrane healing. Failure of a graft was considered to be reperforation during the entire period of follow-up (range 6 months-5 years).

Tympanic membrane healing was successful in 98.54% (337/342) of the cases in which areolar temporalis fascia was used as the graft material. Graft failure for other graft materials was slightly higher. Overall success rate for all 406 cases was 97.5%.

Areolar temporalis fascia is an effective and reliable graft material for primary and revision tympanoplasty. Areolar fascia is readily found in most revision surgeries. Revision tympanoplasty achieved a success rate better than 95%.