Is Cartilage Preferable to Fascia Myringoplasty in Children?

Background

Since the advent of the modern tympanoplasty by Zollner and Wullstein, clinicians have sought the ideal graft material for closure of tympanic membrane perforations. The goals of myringoplasty include both closure of the tympanic membrane to reduce the incidence of infection and restoration of the sound-conducting mechanism of the ear. Thus, graft materials have historically been judged based on their durability and postoperative hearing results. In adults and children, the traditional graft material has been temporalis fascia, with success rates ranging from 60 to 99 percent in adults and 35 to 94 percent in children. In the pediatric population, dysfunction of the Eustachian tube may diminish middle ear ventilation and reduce initial closure or result in subsequent reperforation. For pediatric myringoplasty, it has been suggested that a more robust graft material, such as cartilage, may lead to a more durable repair with hearing results equivalent to fascial repair.

Best Practice

The use of cartilage as a graft material in pediatric myringoplasty is a safe and effective technique. Cartilage grafting has both comparable postoperative hearing results to traditional fascia grafting and the additional advantage of improvement in long-term closure of the tympanic membrane. Read the full article in The Laryngoscope.