Endoscopic type 1 tympanoplasty: comparison of the effects of three different thicknesses grafts

Abstract

Background

The effects of graft thickness on tympanoplasty is uncertain.

Objective

To compare the results of endoscopic tympanoplasty using different thicknesses of autologous tissues.

Methods

This retrospective analysis included 186 patients who received type I tympanoplasty, divided into three main groups based of grafting material: perichondrium (A), cartilage–perichondrium (B), or cartilage–perichondrium plus additional perichondrium (C). Group A was subdivided based on whether the placement was inside (A1) or outside (A2) of the malleus. The hearing improvement, graft success rate, and surgery duration were analysed.

Results

Statistical analysis showed significant hearing improvement in the three main groups (p < .001); recovery in group A occurred the earliest. Six months postoperatively, group A1 showed significantly greater hearing recovery compared with groups B and C (p < .05). There were no statistical differences the other groups (p > .05) or in the graft success rate among the three main groups (p = .235). The surgery duration of group A was significantly longer than that of groups B and C (p < .001).

Conclusion and significance

Our results suggest that graft thickness affects hearing recovery; however, graft thickness does not affect the rate of grafting success. Endoscopic transplantation of the perichondrium is more difficult and requires more time.

Chinese Abstract

背景：移植物厚度对鼓室成形术的影响尚不确定。

目的：比较不同厚度自体组织内镜鼓室成形术的效果。

方法：这项回顾性分析包括 186 名接受 I 型鼓室成形术的患者, 根据移植材料分为三个大组：软骨膜 (A)、软骨-软骨膜 (B) 或软骨-软骨膜加上额外的软骨膜 (C)。 A组根据放置位置再分为锤骨内侧 (A1) 或锤骨外侧 (A2)。对听力改善、移植成功率和手术时间进行分析。

结果：统计分析显示三个大组的听力均有显著改善(p < .001)；A组恢复最早。术后 6 个月, A1 组的听力恢复明显优于 B 组和 C 组（p < .05）。其他组(p > .05) 或三个大组之间的移植成功率（p =0.235）没有统计意义的差异。 A组手术时间明显长于B组和

C组 (p < .001)。

结论和意义：我们的结果表明移植物厚度影响听力恢复；然而, 移植物的厚度并不影响移植的成功率。内镜下移植软骨膜更困难, 需要更多时间。

Keywords:

• Endoscopic surgery
• tympanoplasty
• graft thickness
• tragus perichondrium
• surgery duration

Acknowledgements

We would like to thank Dr Jingbo Wang for her valuable suggestions during the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by National Natural Science Foundation of China [No. 82171146], Zhejiang Provincial Natural Science Foundation of China [No. LZ2211130001] and Wenzhou Science and Technology Bureau [No. 2021Y1174 and Y20210320].