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Abstract

Background: Myringoplasty is a common surgery for repairing the tympanic membrane in chronic otitis media. While the traditional choice of graft is Temporalis fascia, sliced tragal cartilage has gained interest. This study aims to compare the physical and functional outcomes of these grafting materials. Methods: A randomized controlled trial took place at Sahiwal Teaching Hospital over six months from August 2024 till January 2025. It included 60 patients, aged 10 to 70, with chronic tympanic membrane perforation. Patients were randomly assigned to two groups: Group A received myringoplasty with sliced tragal cartilage grafts, and Group B received a Temporalis fascia graft. The results were assessed based on hearing improvement measured by the air-bone gap (ABG) on pure-tone audiometry after surgery, graft acceptance, and three months later using SPSS 27. Results: Both groups had similar basic demographics and comorbidities. The average operative time in the Cartilage Group was 29.81 ± 3.15 minutes, which was significantly shorter than the fascia group at 60.60 ± 4.86 minutes (p < 0.001). The postoperative ABG in the Fascia Group was 14.89 ± 5.47 dB (p = 0.001), while it was lower in the cartilage group at 10.35 ± 4.58 dB. This indicates better functional hearing results for the cartilage group. The graft uptake rate in both groups was satisfactory, and there were no significant differences in complication rates.  Conclusions: The sliced tragal cartilage graft results in less operative time and better postoperative hearing improvement compared to the temporalis fascia in myringoplasty. This makes it a reliable option for tympanic membrane reconstruction.