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Tympanoplasty: Long-Term Results

Long-term results after 878 tympanoplasties using five different methods of repair were analyzed. The five groups were as follows: canal skin and fascia, single fascia, double fascia, canal skin, and canal skin and homograft tympanic membrane. Ten percent of the graft failures occurred 18 months or longer after operation. The highest percentage of graft takes (88%) and satisfactory hearing improvement (socially adequate level 87%, air-bone gap closure to within 15 dB 76%) and the lowest incidence of depression in cochlear reserve (0.7%) was in the double fascia group. Overall hearing results achieved in the 878 tympanoplasties were poorer than anticipated. Differences in results in the five groups, although occasionally large, were not statistically significant. Differences in the percentage of successful graft takes in ears that had no active disease as compared with ears that had active disease and in primary operations as compared with revision operations were not statistically significant. Complications encountered were common and varied.