1 Rizgary Teaching Hospital, Erbil, Iraq

2 Department of Surgery, Medical College, Hawler Medical University


Background: Although temporalis muscle fascia and perichondrium are the commonly used graft materials for the tympanic membrane reconstruction, cartilage-perichondrium graft may be an alternative in obtaining acceptable surgical and audiological outcomes. Aim of study: To evaluate the effectiveness and success of tragal cartilage- perichondrium graft in myringoplasty regarding graft uptake and hearing improvement and to show the effect of patient demographics and perforation site and size on graft uptake rate. Patients and Methods: This prospective study had been carried out on 50 patients who attended the outpatient clinic of otolaryngology, head and neck surgery department, at Rizgary Teaching Hospital in Erbil city/ Iraq during the period of January 2015 to January 2016. All the perforations selected for this study were dry for at least three months and central in type but variable in size. With tragal cartilage as a graft and underlay technique in all cases. Results: Out of 50 patients, 20 were males and 30 were females, their ages range between 12- 49 years with a mean age of 27 years old. Regarding surgical outcome, the overall graft take rate in our study was (86%). In relation to the perforation size; graft take rate in small perforations were (100%), medium-size perforations were (88.9%), large perforations were (85.7%), and subtotal perforations were (75%). In relation to the perforation site; highest graft take rate was in posterior perforations (95.2%) followed by anterior perforation (84.6%) then subtotal perforations (75%). Regarding the functional outcomes, the mean postoperative airbone gap was decreased from 25.63 dB to 13.46 dB with a mean hearing gain of about 12.17 dB. Conclusion: The success rate of cartilage-perichondrium graft in our study was (82%). Best results were obtained in those who were 22-31 years old, in smaller perforations, and in posterior perforations although the p value was statistically not significant. There was significant hearing improvement three months postoperatively.