Optimization of Thickness of Cartilage Graft for Repair of Large and Subtotal Tympanic Perforations in Eustachian Tube Dysfunction

Mokbel KM

Published on: 2020-03-12

Abstract

Objectives: One of the frequently encountered problems that face Otolaryngologists is that when planning to repair tympanic perforation in ears with Eustachian tube dysfunction, and when the surgeon decides to use cartilage, he should choose the ideal functional thickness. Our aim is to evaluate different thicknesses of cartilage grafts to repair tympanic membrane perforation in cases of Eustachian tube malfunctioning.

Patients and Methods: This study has been done between 2013 till 2016, at our tertiary Hospital. 90 patients were enrolled in this study. Cases were divided into two groups. Group A (60) cases with large perforation and group B (30) with subtotal perforation. Each group was divided into 3 graft types (Gr1, 2 and 3) of equal number of cases. Graft1 (Gr1) was full thick cartilage, Graft2 (Gr2) was 0.5mm cartilage and Gr3 was 0.3mm cartilage. Underlay technique was done for all cases. Patients were evaluated clinically and audiologically pre and postoperatively. The data were collected and statistically analysized by using unpaired student t test.

Results: The take rate was 100% in Group A Gr1, group A Gr2, group B Gr1, and group B Gr2. Take rate was 90% and 70% in group AGr3 and group BGr3 respectively. Hearing was significantly improved in group A Gr2 and group B Gr2. Hearing was extremely improved in group A Gr3 and group B Gr3.

Conclusion: The repair of tympanic perforation in cases with eustachian dysfunction should be by cartilage grafts ≥ 0.3mm and ≤ 0.5mm.