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J Audiol Otol > Epub ahead of print
DOI: https://doi.org/10.7874/jao.2022.00108    [Epub ahead of print] Published online September 19, 2022.
Cartilage Graft in Myringoplasty: What Are the Factors Influencing Hearing Gain?
Naourez Kolsi  , Nawress Bouaziz  , Mahdi Ferjaoui  , Khaled Harrathi  , Rachida Bouatay  , Jamel Koubaa 
Department of Otorhinolaryngology & Head and Neck Surgery, University Hospital Fattouma Bourguiba, Monastir, Tunisia
Correspondence  Naourez Kolsi ,Tel: +216-73-106-000, Email: kolsi.naourez@gmail.com
Submitted: March 7, 2022  Accepted after revision: July 13, 2022
Abstract
Background and Objectives
We present the anatomical and functional results on the use of cartilage in myringoplasty and use the data to analyze the factors influencing hearing gain.
Subjects and Methods
This retrospective study included 161 cases of cartilage myringoplasties collected over an 11-year period (2010-2020). Of the 161 cases, the etiology of the tympanic perforations was simple chronic otitis media in 154 (95.65%) ears and traumatic in 7 (4.35%) ears. The mean preoperative Rinne was 26.20±7.05 dB. The most commonly used approach was retroauricular, and the common graft material was tragal or conqual cartilage.
Results
After the follow-up period (mean:15 months), the anatomical success rate was 93.2%; there were nine cases of reperforation, of which three were reoperated with a good final result. The hearing success rate (residual Rinne ≤20 dB) was 91.9% with an average gain of 11.48±8.62 dB. The only factor significantly influencing the anatomical outcome was the history of chronic rhinosinusitis. In univariate studies, several factors influencing the functional result were revealed; the only one retained after elimination of bias was the anatomical result.
Conclusions
We recommend cartilage as the material of choice for myringoplasties as it has been shown to be resistant to predictive factors of failure after tympanic repair surgery. We recommend the adequate management of all chronic rhinosinusitis before performing myringoplasty.
Keywords: Eardrum; Hearing loss; Myringoplasty; Cartilage; Graft
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