Double-Layer Tympanic Membrane Graft in Type I Tympanoplasty

Area of Science:

• Otolaryngology
• Surgical Innovation
• Regenerative Medicine

Background:

• Ongoing debate exists regarding optimal graft materials for tympanic membrane closure.
• Uncertainty persists on whether double-layer grafts surpass single-layer grafts.
• The comparative efficacy of single-layer cartilage versus fascia or perichondrium alone requires clarification.

Purpose of the Study:

• To evaluate the relative effectiveness of single-layer versus double-layer tympanic membrane grafting techniques.
• To compare reperforation rates and hearing outcomes between different grafting methods.

Main Methods:

• Retrospective review of medical records for patients undergoing tympanic membrane repair.
• Analysis of outcomes for three grafting techniques: single-layer perichondrium, single-layer perichondrium with cartilage island, and double-layer perichondrium with cartilage island.
• Assessment of tympanic membrane reperforation and hearing improvement as primary outcomes.

Main Results:

• Double-layer closures demonstrated a significantly lower reperforation rate (90%) compared to single-layer perichondrium (76%) and single-layer perichondrium with cartilage island (78%) grafts.
• No significant difference in reperforation rates was observed between the two single-layer techniques.
• All three groups exhibited statistically significant hearing improvement postoperatively, with no significant differences in preoperative or postoperative hearing levels or overall decibel improvement.

Conclusions:

• Double-layer tympanic membrane closure is associated with reduced rates of reperforation compared to single-layer techniques.
• Hearing outcomes are comparable across single-layer and double-layer grafting methods.
• Double-layer closure represents a more effective strategy for achieving successful tympanic membrane repair.