Cartilage Tends To Be a Better Choice than Temporalis Fascia for Tympanoplasty under the Circumstance of Eustachian Tube Dysfunction
Huaili Jiang and Zhigang Zhang*
Abstract:
Objective: to investigate whether cartilage or temporalis fascia is more ideal for tympanoplasty under the circumstance of Eustachian tube (ET) dysfunction.
Material and methods: Firstly, we summarized some biological comparisons among tympanic membrane, cartilage and temporalis fascia. Secondly, we conducted a meta-analysis that involved three randomized controlled trials (RCT) to compare their difference in improving hearing level and morphological success rate.
Results: in terms of biological properties, cartilage was stiffer than temporalis fascia. But cartilage can be cut into different thickness to balance the ability of acoustic sensitivity and resistance to negative pressure induced by ET dysfunction, which was impossible for temporalis fascia. When it came to clinical properties, there was no statistical significance between cartilage and temporalis fascia in postoperative air-bone gap≤ 20dB (p=0.61) and 20dB (p=0.25) in 24 months. However, cartilage showed better morphological success in 12 months with p=0.04.
Conclusions: Cartilage should be cut as thin as possible if ET function was normal. However, under the circumstance of ET dysfunction, cartilage with more than 500um thickness was supposed to be the first choice for tympanoplasty.
Huaili Jiang and Zhigang Zhang*
Abstract:
Objective: to investigate whether cartilage or temporalis fascia is more ideal for tympanoplasty under the circumstance of Eustachian tube (ET) dysfunction.
Material and methods: Firstly, we summarized some biological comparisons among tympanic membrane, cartilage and temporalis fascia. Secondly, we conducted a meta-analysis that involved three randomized controlled trials (RCT) to compare their difference in improving hearing level and morphological success rate.
Results: in terms of biological properties, cartilage was stiffer than temporalis fascia. But cartilage can be cut into different thickness to balance the ability of acoustic sensitivity and resistance to negative pressure induced by ET dysfunction, which was impossible for temporalis fascia. When it came to clinical properties, there was no statistical significance between cartilage and temporalis fascia in postoperative air-bone gap≤ 20dB (p=0.61) and 20dB (p=0.25) in 24 months. However, cartilage showed better morphological success in 12 months with p=0.04.
Conclusions: Cartilage should be cut as thin as possible if ET function was normal. However, under the circumstance of ET dysfunction, cartilage with more than 500um thickness was supposed to be the first choice for tympanoplasty.
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