Comparison between Tragal Cartilage and Temporal Fascia in Tympanoplasty

Abstract

Introduction: Tympanoplasty is a widely performed procedure to repair tympanic membrane perforations and improve hearing. Among the commonly used graft materials, Tragal Cartilage and Temporal Fascia have shown varying outcomes. Aims: This study aims to compare the surgical and audiological results of tympanoplasty using Tragal Cartilage versus Temporal Fascia grafts.

Methods: This prospective, randomized, comparative study was conducted in the Department of ENT at Dr. Panjabrao Deshmukh Memorial Medical College, Amravati and at Aakanksha ENT clinic, Amravati, over a period of 19 months from January 2024 to July 2025. A total of 100 patients diagnosed with chronic suppurative otitis media (CSOM), tubotympanic type with dry central perforation, were enrolled in the study. Patients were randomly divided into two equal groups for surgical intervention. Group A (n = 50) underwent tympanoplasty using tragal cartilage graft, while Group B (n = 50) underwent tympanoplasty using temporal fascia graft.

Results: The comparison of audiological outcomes between the two groups revealed significant differences in hearing improvement. The mean preoperative Pure Tone Average (PTA) was comparable between the Tragal Cartilage (42.6 ± 6.8 dB) and Temporal Fascia (43.1 ± 7.1 dB) groups (p = 0.697). However, the mean postoperative PTA was significantly better in the Temporal Fascia group (24.3 ± 5.1 dB) compared to the Tragal Cartilage group (29.8 ± 5.9 dB) (p < 0.001). Consequently, the mean hearing gain was significantly higher in the Temporal Fascia group (18.8 ± 4.2 dB) than in the Tragal Cartilage group (12.8 ± 3.4 dB) (p < 0.001). These findings indicate superior audiological outcomes with the use of Temporal Fascia grafts.

Conclusion: While both Tragal Cartilage and Temporal Fascia are effective graft materials for tympanoplasty, Temporal Fascia offers superior hearing improvement, reduced operative time, and higher patient satisfaction, making it the preferred choice in suitable cases.