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Abstract
Objective: To compare the audiological outcomes and graft uptake rates of temporalis fascia and tragal cartilage grafts in patients undergoing endoscopic myringoplasty.
Methods: This prospective, comparative, interventional study was conducted at the Pak Emirates Military Hospital in Rawalpindi from December 2024 to August 2025. A total of 114 patients aged 18–45 years with conductive hearing loss undergoing Myringoplasty were enrolled and equally allocated to a temporalis fascia (TF) group (n=57) and a tragal cartilage (TC) group (n=57). Underlay endoscopic Myringoplasty was performed in both groups. The primary outcome was hearing improvement assessed by air–bone gap (ABG), while graft uptake was considered the secondary outcome. Data were analysed using appropriate non-parametric and categorical statistical tests, with p≤0.05 considered statistically significant.
Results: Baseline characteristics were comparable between the groups (p>0.05). Successful graft uptake was significantly higher in the TC group than in the TF group (96.49% vs. 82.45%; χ²=5.961, p=0.015). The median postoperative ABG was significantly lower in the TF group than in the TC group [8.0 (5.0–10.0) vs. 11.0 (8.5–13.0) dB; p<0.001]. Similarly, hearing gain was significantly greater in the TF group [11.0 (9.0–15.0) dB] than in the TC group [9.0 (6.5–11.0) dB] (p<0.001).
Conclusion: Tragal cartilage grafts provide superior graft uptake, whereas temporalis fascia grafts yield better hearing outcomes following endoscopic myringoplasty.
Keywords: Audiometry, Cartilage Graft, Hearing outcomes, Middle ear pathology, Myringoplasty, Temporalis fascia graft
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