Comparison of Perichondrium Reinforcement and the Use of a Cartilage–Perichondrium Composite Graft Alone in the Repair of Subtotal Perforation: A Semi-Random Study

Objective Graft outcomes and complications were compared in patients who received a cartilage–perichondrium composite graft via perichondrium reinforcement (CPPR) and those treated using only a cartilage–perichondrium composite graft underlay (CPGU) technique, including raising a tympanomeatal flap, in the repair of a subtotal perforation. Materials and Methods Patients with subtotal perforations were semi-randomly allocated to the CPPR and CPGU groups. The graft success rate, hearing outcomes, operation times, postoperative visual analog scale (VAS) values, and complications were compared for up to 6 months postoperatively. Results The sample consisted of 67 ears from 67 patients. The mean operation time was 33.1 ± 2.8 min in the CPPR group and 56.2 ± 1.8 min in the CPGU group. At 6 months postoperatively, the VAS scores were 1.4 ± 0.9 and 3.7 ± 1.2, and the graft success rates were 97.0% and 88.2% (P = .371), respectively. There were no significant differences in the mean gain in the air–bone gap (16.2 ± 5.3 vs. 14.7 ± 6.2) between the two groups, but hearing improvement was greater in the CPPR group. Ear fullness was reported by 21.2% patients in the CPPR group and 91.2% of patients in the CPGU group. Temporary hypogeusia developed in 3.0% of patients in the CPPR group and 38.2% of those in the CPGU group. Myringitis was seen in 9.1% patients in the CPPR group and 2.9% in the CPGU group. Conclusion In patients undergoing subtotal perforation repair, the 6-month graft outcome in patients treated with the perichondrium reinforcement technique without raising a tympanomeatal flap and external ear canal packing was similar to that of patients who underwent a flap-raising technique. The advantages of the perichondrium reinforcement technique are that it is simple, time-saving, and minimally invasive, with less ear fullness and better hearing recovery.