Myringoplasty With an Ultrathin Cartilage-Perichondrium Complex Graft Versus Temporalis Fascia Graft: A Propensity Score-Matched Analysis.

Abstract

To compare endoscopic myringoplasty using the cartilage-perichondrium complex as a graft (test group) with temporalis fascia microscopic myringoplasty (control group). A retrospective cohort study. Department of Otorhinolaryngology in a tertiary Chinese hospital. Data were collected on patients between 2017 and 2019. To balance the baseline characteristics between groups, we performed a propensity score-matched analysis, and 44 patients were included in each group. Hearing improvement and eardrum closure rates were compared, and risk factors affecting them were analyzed. In the control and test groups, 90.90% and 86.36% of patients had a mean air-bone gap ≤20 dB after the surgery, respectively (<i>P</i> = .843). The air conduction (AC) threshold gain at each frequency was similar in the 2 groups (<i>P</i> > .05). The closure rates were 95.45% and 93.18%, respectively (<i>P</i> = .645). The air-bone gap improved significantly after surgery, <i>F</i>(1, 61) = 6.729, <i>P</i> = .012. Age, group, middle ear mucosal status, and location of the perforation did not affect the change in air-bone gap or the drum closure rate (<i>P</i> > .05). However, there was an interaction between the change in air-bone gap and the size of the perforation, <i>F</i>(1, 61) = 11.067, <i>P</i> = 0001. Endoscopic myringoplasty using a cartilage-perichondrium complex graft is comparable with traditional surgery. Age, location of the perforation, and middle ear mucosal status did not significantly affect the change in air-bone gap or the drum closure rate. A perforation size ≥50% was always associated with a better air-bone gap improvement.