Abstract
Objective: Hearing performance after myringoplasty with
full-thickness tragal cartilage (FTTC) has been questioned because a
considerable difference exists between the graft and natural tympanum.
This study aimed to analyze the air-bone gap (ABG) trends before and
after myringoplasty and its interaction with risk factors in the FTTC
group; further, it compared postoperative ABG in the FTTC group to that
in the
temporalis
fascia (TF) and partial-thickness
tragal cartilage (PTTC) groups.
Design: A retrospective cohort study
Setting: Tertiary care University Hospital
Methods: The general linear model repeated measures was used to
analyze ABG trends in the FTTC group and its influencing factors.
Non-parametric tests were used to compare ABGs in the FTTC group and the
other two groups. Propensity score matching was done to balance baseline
characteristics between the TF and FTTC group.
Results: The mean postoperative ABG in the FTTC group was
12.17±6.58 dB, and 90.9% of the patients had a mean ABG within 20 dB,
which improved significantly after surgery
(F(1,108)=38.707, P <.001). The tympanic
perforation size and malleus handle exposure status, which significantly
affected the preoperative ABG, did not affect postoperative hearing
(P >.05). In the FTTC group, the mean ABG was
comparable to that in the other two groups (P >.05).
For all except 250 Hz, a similar audiological performance was observed
in the FTTC and PTTC groups; FTTC had a better performance at 250 Hz
(Z=-2.277, P =.023).
Conclusions: Good hearing performance was achieved after
myringoplasty with FTTC, irrespective of the preoperative perforation
size and malleus handle exposure status.
Keywords: cartilage; hearing tests; linear models;
myringoplasty; propensity score; retrospective studies