Tragal Perichondrium and Composite Cartilage Graft Complimenting Endoscopic Tympanoplasty in True Sense: A Comparison

INTRODUCTION: In days of scar less surgeries it has become necessary for otologists to concentrate on tympanoplasties without external incisions. This study compares the anatomical and functional results of tragal perichondrium graft and perichondrium-cartilage composite graft for transcanal endoscopic tympanoplasties in Himalayan region. METHODS AND MATERIALS: This prospective study included 60 subjects of chronic otitis media (mucosal type), who underwent transcanal endoscopic underlay type I tympanoplasty and were divided into two groups. In 30 cases tragal perichondrium graft and in rest of 30 cases Tragal perichondrium Cartilage composite graft was used. Anatomical and functional outcomes were evaluated at 6 months time. RESULTS: Hearing gain comparing Audiometric data between the tragal perichondrial graft group and tragal perichondrial cartilage composite graft group at 6 months showed no statistically significant differences (P= 0.9533). Assessment of anatomical outcome indicated a greater number of complications in the tragal perichondrial graft group although it was not statistically significant (P=0.6360 in anterior graft failure group, P =0.1322 in reperforation group and P= 0.1056 in retraction group). CONCLUSION: Functional results validated both the grafting material while anatomical results are slightly better in tragal perichondrial cartilage composite graft group in term of re perforation and retraction. Moreover use of tragal grafts endoscopic tympanoplasty fulfils its true meaning as no visible scar and post operative patient morbidity is prevented.