Results
Records of 165 type-1 tympanoplasty cases operated with PCG, ICG, and WsCCG were obtained and 111 patients included final analysis according to inclusion criteria. 58 (52.3%) of the patients were female and 53 (47.7%) were male. The mean age was 33.3±14.9 years for all patients. 39 patients (35.1%) with PCG, 36 (32.4%) patients with WsCCG and 36 (32.4%) patients with ICG were included in the study groups. The graft success rate was 91.0% in all patients at the end of 30.6±10.1 (min: 26 max: 44) months of follow-up. PTA was 33.0±7.2 dB, ABG was 22.7±6.6 dB and the word recognition score (WRS) was 94.5±6.6% in all patients preoperatively. The Kolmogorov Smirnov test showed that preoperative variables were normally distributed in all three cartilage graft groups (p>0.05). According to the OneWay Anova test, there was no statistically significant difference between age, preoperative PTA, ABG, WRS and follow-up times (Table 1).
There was no significant relationship between graft success and graft type.(p=0.224, χ² test). (Table 2). A statistically significant decrease for PTA and ABG means and a significant increase for WRS means were detected after the surgery (p= 0.000, 0.004, 0.049, respectively, t-test). Average of postoperative PTA and ABG closure were significantly affected by the cartilage graft type, but WRS values was not affected by the cartilage graft type (p = 0.005, 0.019, 0.306, respectively, OneWay-Anova test) (Table 3). Post-Hoc tests showed a statistically significant decrease in PTA and ABG closure for WsCCG group compared to the ICG group (p = 0.004; CI = 15.1-2.2 dB and p = 0.023; CI = 8.2-0.4, respectively). Postoperative PTA and ABG averages for WsCCG and PCG groups were similar (p= 0.069 and p=0.053, respectively). Multiple comparisons of the graft groups for postoperative PTA, ABG closure were given in Table 4. However, according to the multivariate analysis, the postoperative PTA, ABG closure, WRS, and the graft success are not affected by the type of cartilage graft (p = 0.647, 0.799, 0.232, 0.377 respectively).
Two of four failure cases were retractions development between cartilage slices in the PCG group. One of the graft failures was due to retraction, and four were marginal perforations in the ICG group. One graft failure in WsCCG group was perforation at the anterior margin of TM.