Long-Term Graft Uptake Rates in Cartilage T-Plasty versus Classical TPlasty: A Comparative Analysis

Background: Tympanoplasty remains the gold standard surgical intervention for tympanic membrane perforation repair in chronic otitis media. The selection of graft material significantly influences surgical outcomes. Cartilage and temporalis fascia represent the two most commonly utilized materials, each offering distinct advantages. Methods: A prospective comparative cohort study was conducted involving 180 patients (90 per group) undergoing Type I tympanoplasty. The cartilage group received tragal cartilage grafts, while the classical group received temporalis fascia grafts. Primary outcomes included graft uptake success rates at 6, 12, and 24 months postoperatively. Secondary outcomes comprised air-bone gap (ABG) closure, pure-tone average (PTA) improvement, and complication rates. Statistical analyses utilized chi-square tests, independent t-tests, and logistic regression. Results: At 24 months, graft uptake success was 94.4% (85/90) in the cartilage group versus 86.7% (78/90) in the classical group (p = 0.048). Mean ABG improvement was 15.8 ± 5.4 dB in the cartilage group and 17.2 ± 6.1 dB in the classical group (p = 0.125). The cartilage group demonstrated superior outcomes for large perforations (>50%) with success rates of 92.1% versus 78.6% (p = 0.024). Mean preoperative ABG was 28.6 ± 8.2 dB (cartilage) and 27.9 ± 7.8 dB (classical). Postoperative ABG at 24 months was 12.8 ± 6.1 dB (cartilage) versus 10.7 ± 5.3 dB (classical). Complication rates were comparable between groups (6.7% vs 8.9%, p = 0.587). The cartilage group showed significantly lower re-perforation rates (3.3% vs 10.0%, p = 0.038). Conclusion: Cartilage T-Plasty demonstrates superior long-term graft uptake rates compared to Classical TPlasty, particularly for large and challenging perforations, with comparable audiological outcomes. The findings support cartilage as a reliable alternative graft material with enhanced structural stability for tympanoplasty.