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Techniques of Endoscopic Ossiculoplasty
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Three autologous substitutes for myringoplasty: a comparative study.

Zhi Gang Zhang1, Qiu Hong Huang, Yi Qing Zheng

  • 1Department of Otolaryngology Head and Neck Surgery, the 2nd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China. zhangzz0369@126.com

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|September 17, 2011
PubMed
Summary

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For small eardrum perforations, all autologous grafts are effective for myringoplasty. Cartilage-perichondrium composite grafts offer superior long-term results for large perforations, improving hearing and eardrum structure.

Area of Science:

  • Otolaryngology
  • Regenerative Medicine
  • Surgical Innovation

Background:

  • Myringoplasty is a surgical procedure to repair tympanic membrane perforations.
  • Autologous grafts are commonly used, but their efficacy varies.
  • Choosing the optimal graft material is crucial for successful outcomes.

Purpose of the Study:

  • To evaluate and compare the effectiveness of three autologous graft materials for myringoplasty.
  • To assess graft acceptance, hearing outcomes, and tympanic membrane morphology.
  • To determine the best graft choice for different perforation sizes.

Main Methods:

  • Retrospective review of 117 myringoplasty cases performed by a single surgeon.
  • Grafts used: temporalis fascia, tragus perichondrium, and tragus cartilage-perichondrium composite.

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  • Outcomes assessed via otoscopy and pure-tone average air-bone gap measurements.

    • Main Results:

    • 100% graft acceptance with 100% graft take for small perforations using any autologous substitute.
    • Cartilage-perichondrium composite grafts showed the highest acceptance rate for large perforations (p < 0.05) at 1 year.
    • Temporalis fascia and perichondrium grafts had higher rates of re-perforation or invagination in large perforation cases.

    Conclusions:

    • All three autologous graft types are suitable for simple myringoplasty with minor tympanic membrane perforations.
    • Cartilage-perichondrium composite grafts demonstrate superior long-term benefits for large perforations.
    • This graft material enhances both hearing improvement and tympanic membrane morphology in challenging cases.