Comparative Study Between Perichondrium and Composite Cartilage/Perichondrium in Endoscopic Myringoplasty for Total and Subtotal Perforations

Background; Perforations of the tympanic membrane (TM) are frequently encountered problems, often as a result of middle ear infections, traumatic injury, or complications following surgery. Although the TM has the ability to heal itself, surgical intervention may be required for chronic perforations. Aim and objectives; To compare the graft take rates and the postoperative hearing results in endoscopic trans-canal myringoplasty operations using the tragal cartilage and perichondrium composite graft technique with those of tympanoplasties using perichondrium graft technique for total and subtotal TM perforations. Patients and methods: This prospective study was conducted on 40 patients who had non-cholesteatomatous chronic suppurative otitis media and had total or subtotal perforations. The patients were divided randomly into two groups for comparison in the study. Result: There was higher closure rate/graft take in composite cartilage/perichondrium group compared to the perichondrium group; however, the difference was of no statistically significant value. The case was considered to be successful if there is complete healing of TM with hearing improvement (decrease ABG). Cases with residual perforation or those who showed no hearing improvement postoperatively are considered failed. Conclusion: There was higher success and hearing improvement postoperatively in composite cartilage/perichondrium group compared to the perichondrium group; however, the difference was of no statistically significant value. Further research with larger sample size is necessary in the detection of the efficacy of using the tragal cartilage and perichondrium composite graft technique for repairing TM perforation.