Abstract Background: Type 1 tympanoplasty commonly using temporalis fascia, full-thickness cartilage, or sliced cartilage grafts. This study compares the functional outcomes of these grafts in terms of speech reception threshold (SRT), speech discrimination score (SDS), and pure tone audiometry (PTA). Setting: A prospective, randomized interventional study with 116 patients of mucosal chronic otitis media over 24 months. Setting: A prospective interventional study was conducted at SRMS Institute of Medical Sciences over 24 months. Study Design: 129 Patients underwent tympanoplasty using temporalis fascia (Group A), full-thickness cartilage (Group B), or sliced cartilage (Group C). Materials and Methods: SRT, SDS, and PTA (air-bone gap ABG) were evaluated preoperatively and postoperatively. Statistical analysis was performed to compare outcomes. Results: Temporalis fascia demonstrated the highest percentage improvement in ABG (63.13%) and achieved significant enhancements in PTA (mean improvement: 15.9 ± 3.2 dB) and SRT (20.6 ± 2.0 dB). Full-thickness cartilage showed the greatest absolute ABG improvement (17.01 ± 2.1 dB) but had a lower percentage improvement (53.02%). Its moderate auditory gains were offset by its superior structural resilience. Sliced cartilage provided balanced improvements in PTA (18.2 ± 2.5 dB) and SRT (22.1 ± 2.3 dB), with a percentage ABG improvement of 49.78%. Across all graft types, SDS values remained consistent, indicating that graft material had minimal influence on speech discrimination outcomes. Conclusion: Temporalis fascia remains the most effective graft for maximizing auditory outcomes, Full-thickness cartilage is better suited for patients requiring structural resilience, whereas sliced cartilage combines the benefits of both materials.
Rana et al. (2025) studied this question.