A Comparative Study of Cartilage vs. Temporalis Fascia Graft in Endoscopic Tympanoplasty

This study aims to compare the efficacy of cartilage and temporalis fascia grafts in endoscopic tympanoplasty, focusing on graft uptake success rates and postoperative hearing outcomes. A prospective interventional randomized study was conducted from 2022 to 2024 in a tertiary care hospital, involving 60 patients aged 18-60 years with chronic otitis media (COM), tubotympanic type of disease. Patients were randomly divided into two groups: 30 underwent tympanoplasty with temporalis fascia grafts, and 30 received cartilage grafts. All surgeries were performed endoscopically using the transcanal approach. Graft uptake success was assessed postoperatively at 1, 3, and 12 weeks. Hearing outcomes were evaluated by comparing preoperative and postoperative air-bone gap (ABG) and pure-tone average (PTA) values at 500 Hz, 1 kHz, 2 kHz, and 3 kHz. Cartilage grafts provide superior structural stability and higher graft uptake success rates, while temporalis fascia grafts offer marginally better short-term hearing outcomes. Both materials significantly improve hearing, but cartilage exhibits greater resistance to re-perforation and long-term durability. The choice of graft material should be tailored to patient-specific factors for optimal surgical success and auditory restoration.