Is type 1 tympanoplasty effective in elderly patients? Comparison of fascia and perichondrium grafts

Abstract

Background: Tympanoplasty is regularly performed in various ages but data about the procedure in elderly is insufficient.

Objectives: To compare the success rates and hearing outcomes of fascia and perichondrium grafts used for tympanoplasty in patients >65 years and to evaluate the prognostic factors affecting the success of tympanoplasty.

Methods: Reviewing records of 49 elderly patients underwent tympanoplasty, two groups were constituted: perichondrium (25 patients) and fascia (24 patients) groups. Ages, genders, perforation sides, type and location of perforation, graft success rates, functional success rates and air–bone gap (ABG) gains were compared.

Results: Overall graft success rate was 85.7%. After a mean follow-up of 23.3 ± 8.32 months, overall mean ABG gain was 11.33 ± 8.42 dB. Overall median postoperative ABG value (9 dB) was significantly lower compared to the median preoperative value (24 dB) (p < .001). Graft success rate was higher in perichondrium group (96%) compared to fascia group (75%) (p = .04). Functional success rate did not significantly differ between perichondrium (68%) and fascia groups (62.5%) (p = .68).

Conclusion and significance: Tympanoplasty is an effective procedure with a graft success rate of 85.7% in elderly. Both fascia and perichondrium are suitable materials; however, perichondrium had higher success rate.

Chinese abstract

背景：鼓室成形术通常对不同年龄段的患者进行, 但有关老年人手术的资料不足。

目的：比较用于65岁以上患者鼓室成形术的筋膜和软骨膜移植物的成功率和听力结果, 并评估影响鼓室成形术成功的预后因素。

方法：回顾49例接受鼓室成形术的老年患者的记录, 分为两组：软骨膜组（25例）和筋膜组（24例）。比较年龄、性别、穿孔侧、穿孔类型和位置、移植成功率、功能成功率和气骨间隙（ABG）增益。

结果：总移植成功率为85.7％。平均随访23.3±8.32个月后, 总体平均ABG增益为11.33±8.42 dB。总术后中位数ABG增益值（9 dB）显著低于术前中位值（24 dB）（p <.001）。与筋膜组（75％）相比, 软骨膜组（96％）的移植成功率更高（p = 0.04）。功能成功率在软骨膜（68％）和筋膜组（62.5％）之间没有显著差异（p = .68）。

结论和意义：鼓室成形术是一种有效的方法。老年人的移植成功率为85.7％。筋膜和软骨膜都是合适的材料；然而, 软骨膜的成功率更高。

Keywords:

• Elderly
• tympanoplasty
• fascia
• perichondrium
• success

Disclosure statement

The authors have no conflict of interest to declare.