Success rates for various graft materials in tympanoplasty - A review

Abstract

Objectives: The aim of this paper is to review how successful each type of grafts is in tympanoplasty.

Methods: Pubmed, Google and the Proquest Central Database at Kırıkkale University were queried using the keywords "graft", "success" "tympanoplasty", "success rate" with the search limited to the period 1955 to 2017.

Results: Various types of graft materials including temporalis fascia, cartilage, perichondrium, periosteum, vein, fat or skin have been used in the reconstruction of tympanic membrane (TM) perforation. Although temporalis fascia ensures good hearing is restored, there are significant concerns that its dimensional stability characteristics may lead to residual perforation, especially where large TM perforations are involved. The "palisade cartilage" and "cartilage island" techniques have been stated to increase the strength and stability of a tympanic graft, but they may result in a less functional outcome in terms of restoring hearing. Smoking habits, the size and site of a perforation, the expertise level of the operating surgeon, age, gender, the status of the middle ear mucosa and the presence of myringosclerosis or tympanosclerosis are all important in determining how successful a graft is.

Conclusion: Although temporal fascia is the most commonly used graft material for tympanoplasty, poor graft stability may cause failure. This failure is due to the inclusion of connective fibrous tissue containing irregular elastic fibers present in the grafted fascia. Cartilage grafts offer better ability to resist infection, pressure, and cope with insufficient vascular supply. This means that cartilage grafts are suitable for use in revision cases.

Keywords: Graft; Success; Success rate; Tympanoplasty.