Comparison between Temporalis Fascia and Tragal Cartilage Tympanoplasties in the Management of Chronic Pars Tensa Retractions

Background: Retractions of the Pars Tensa of the Tympanic membrane are an unwanted consequence of sharp variations in middle-ear pressure related to the functionality of the Eustachian Tube. Such retractions can cause conductive hearing loss because of either fixation of the ossicular chain or necrosis. This study aims to compare the advantages and disadvantages of Tragal Cartilage and Temporalis Fascia as graft materials in the management of Pars Tensa Retractions with focus on hearing thresholds. Methods: A prospective comparative study was conducted on 60 patients with unilateral Pars Tensa retractions and conductive hearing loss. Patients were randomized into two groups: Group A underwent tympanoplasty using Tragal Cartilage, while Group B received Temporalis Fascia graft, all under General Anaesthesia. Pre-operative and post-operative hearing outcomes were assessed using Pure Tone Audiometry and Impedance Audiometry. Results: One month postoperatively, Group B had a better Air Conduction Threshold ( P =0.04) and Air-Bone Gap ( P =0.03). However, at six months, Group A demonstrated superior hearing outcomes ( P =0.01) and lower failure rates (10% vs. 30%, P =0.02). Tympanograms also favored Group A, with 86.7% achieving Type A compared to 63.3% in Group B (p<0.01). Conclusion: Although the management of chronic recurrent Pars Tensa retractions is fairly simple, the patients should always be promised only a guarded result. It can be seen from the results of our study that although both graft materials have good long term results, Cartilage seems to perform better in bridging the ABG and having lesser recurrence rates.