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Evaluation of hearing outcome of tympanoplasty using cartilage graft versus temporalis fascia graft



Various materials such as fascia, perichondrium, and cartilage have been used for the reconstruction of the tympanic membrane in middle ear surgery. Owing to its stiffness, cartilage is resistant to resorption and retraction.

Patients and Methods

This study comprised a randomized, controlled trial conducted to analyze the audiological gain when using cartilage grafts in type 1 tympanoplasty compared with temporalis fascia grafts on 60 patients suffering from chronic otitis media after successful tympanoplasty. The follow-up period was at least 6 months. All patients were subjected to audiological evaluation before and at least 6 months postoperatively.


There was a significant reduction in mean air-bone gap (ABG) in both groups, whereas in group A (fascial graft) the mean preoperative ABG was 25±10.2 dB and the mean postoperative ABG was 13.5±7.3 dB, whereas in group B (cartilage graft) the mean preoperative ABG was 30.6±8.6 dB and the mean postoperative ABG was 15.9±8.7 dB, analyzing the effectiveness of both surgical techniques showed that both were equally effective in reducing ABG from preintervention to postintervention with no statistical significance among both groups (P=0.212).


Patients who had cartilage grafts showed similar hearing outcomes to those who had fascial grafts after a successful tympanoplasty procedure.


  1. 1

    Lim DJ. Recent advances in otitis media. Report of the Eighth Research Conference. Ann Otol Rhinol Laryngol 2005; 114:1.

    Google Scholar 

  2. 2

    Acuin J. Chronic suppurative otitis media. Clin Evid 2004; 12:710.

    Google Scholar 

  3. 3

    Yates PD. Otitis media. In: Lalwani AK, editor. Current diagnosis and treatment in otolaryngology – head and neck surgery. 1st ed. McGraw Hill Companies; 2005. pp. 655–665.

  4. 4

    Acuin J, Smith A, MacKenzie I. Interventions for chronic suppurative otitis media (Cochrane Review). Cochrane Database Syst Rev 2001; 2: CD000473.

    Google Scholar 

  5. 5

    Bluestone CD. Studies in otitis media: Children’s Hospital of Pittsburgh-University of Pittsburgh progress report. Laryngoscope 2004; 114:1–26.

    Article  Google Scholar 

  6. 6

    Demirci S, Tuzuner A, Karadas H, Acıkgoz C, Caylan R, Samim E. Comparison of temporal muscle fascia and cartilage grafts in pediatric tympanoplasties. Am J Otolaryngol 2014; 35:796–799.

    Article  Google Scholar 

  7. 7

    Kalcioglu M, Tan M, Croo A. Comparison between cartilage and fascia grafts in type 1 tympanoplasty. B-ENT 2013; 9:235–239.

    CAS  PubMed  Google Scholar 

  8. 8

    Yegin Y, Çelik M, Koç AK, Küfeciler L, Elbistanlı M, Kayhan F. Comparison of temporalis fascia muscle and full-thickness cartilage grafts in type 1 pediatric tympanoplasties. Braz J Otorhinolaryngol 2016; 82:695–701.

    Article  Google Scholar 

  9. 9

    Kim JY, Oh JH, Lee HH. Fascia versus cartilage graft in type I tympanoplasty: audiological outcome. J Craniofac Surg 2012;23: e605–e608.

    Article  Google Scholar 

  10. 10

    Tek A, Karaman M, Uslu C, Habeşoğlu T, Kılıçarslan Y, Durmuş R, et al. Audiological and graft take results of cartilage reinforcement tympanoplasty (a new technique) versus fascia. Eur Arch Otorhinolaryngol 2012; 269:1117–1126.

    Article  Google Scholar 

  11. 11

    Callioglu EE, Ceylan BT, Kuran G, Demirci S, Tulaci KG, Caylan R. Cartilage graft or fascia in tympanoplasty in patients with low middle ear risk index (anatomical and audological results). Eur Arch Otorhinolaryngol 2013; 270:2833–2837.

    Article  Google Scholar 

  12. 12

    Jalali MM, Motasaddi M, Kouhi A, Dabiri S, Soleimani R. Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 2017; 127:2139–2148.

    Article  Google Scholar 

  13. 13

    Yang T, Wu X, Peng X, Zhang Y, Xie S, Sun H. Comparison of graft and fascia in type 1 tympanoplasty: systematic review and meta-analysis. Acta Otolaryngol 2016; 136:1085–1090.

    CAS  Article  Google Scholar 

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Corresponding author

Correspondence to Mohamed M. El-Sheikh MD.

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El-Sheikh, M.M. Evaluation of hearing outcome of tympanoplasty using cartilage graft versus temporalis fascia graft. Egypt J Otolaryngol 35, 1–5 (2019).

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  • cartilage graft
  • fascial graft
  • hearing outcome
  • tympanoplasty