Comparative Study of Augmentation of Stapes Head with Tragal Cartilage versus Only Temporalis Fascia in Cases of Type III Tympanoplasty with Canal Wall Down Mastoidectomy

Objective: The objective of the study was to compare pre- and postoperative hearing results after cartilage augmentation over the stapes head in canal wall down mastoidectomy, and also to observe if there are any other considerations. Materials and Methods: Patients more than 10 years of age with squamous chronic otitis media with conductive or mixed hearing loss, with mobile stapes footplate and intact stapes suprastructure, operated for canal wall down mastoidectomy were included in our study. Patients with sensorineural hearing loss and revision surgeries were excluded from our study. Postoperative hearing was assessed in terms of air-bone gap closure on pure tone audiometry for both the groups, with and without cartilage augmentation, at the 6-month postoperative period. Otoendoscopy findings in terms of graft uptake and condition of the mastoidectomy cavity were also noted for both the groups. Results: Mean hearing gain in group with cartilage augmentation was 12.58 dB while in the group without augmentation, the gain was found to be 7.08 dB. The difference was found to be statistically significant on application of Student’s t- test. No significant difference was found in terms of healing and the condition of the mastoidectomy cavity in both the groups. Conclusion: Tragal cartilage is an easily available and economical graft material for augmentation in Type III tympanoplasty with canal wall down mastoidectomy. It also offers a significant advantage in hearing by increasing the effective vibrating area of the tympanic membrane graft.