Hearing outcomes after endoscopic type I tympanoplasty: a frequency-range comparison of perichondrium and tragal...

To compare postoperative hearing outcomes across different frequency ranges following endoscopic type I tympanoplasty using perichondrium or tragal cartilage grafts.

Consecutive patients undergoing endoscopic type I tympanoplasty for inactive chronic otitis media with tympanic membrane perforation between January 2021 and September 2025 were retrospectively identified from our institutional database. Patients with cholesteatoma, ossicular abnormalities, severe sensorineural hearing loss, revision surgery, eustachian tube dysfunction, follow-up shorter than 3 months were excluded. Air-bone gap (ABG) improvement was defined as postoperative reduction in ABG. Air-bone gaps (ABGs) were evaluated at low frequencies (average of 0.25 and 0.5 kHz) and full frequencies (average of 0.5,1,2,4 kHz). Analysis of covariance was performed to adjust for baseline hearing differences.

Of 143 screened patients, 101 met the inclusion criteria, including 54 receiving perichondrium grafts and 47 receiving tragal cartilage grafts. Baseline low-frequency and full-frequency ABGs differed significantly between groups. After adjustment for baseline differences, postoperative ABGs did not differ significantly between groups at either low- frequency ranges (adjusted mean difference 2.1 dB, 95% CI -0.7 to 4.8, P = .136) or full-frequency ranges (adjusted mean difference -2.1 dB, 95% CI -4.6 to 0.5, P = .112). Both groups demonstrated significant postoperative hearing improvement with stable bone-conduction thresholds.

Both perichondrium and tragal cartilage grafts achieved comparable short-term anatomical and audiological outcomes after endoscopic type I tympanoplasty. Frequency-range evaluation did not identify clinically meaningful differences between graft materials beyond those detected by conventional pure-tone average measures after adjustment for baseline hearing status. Further prospective studies with longer follow-up are warranted to confirm these findings.