Ring versus 'Mercedes-Benz' cartilage-perichondrium graft tympanoplasty in management of pars tensa cholesteatoma.

OBJECTIVE

To compare anatomical and audiological outcomes of ring versus 'Mercedes-Benz' cartilage-perichondrium graft tympanoplasty in patients with pars tensa cholesteatoma.

STUDY DESIGN

Prospective clinical study.

SETTING

Otolaryngology department, Tanta University Hospital, Egypt.

PATIENTS AND METHODS

Over three years, 60 ears in 60 patients underwent surgery for either sinus or tensa retraction cholesteatoma, reconstructed using either a ring-shaped (30 ears) or Mercedes-Benz symbol shaped (30 ears) cartilage-perichondrium graft, with at least two years' follow up. Post-operative drum perforation and retraction, cholesteatoma residue and recurrence, middle-ear effusion, and hearing acuity were monitored.

RESULTS

Anatomical outcomes were equivalent in both groups, but slightly better in the Mercedes group. Hearing improved significantly in both groups (pre- vs post-operative results), but significantly more so in the ring group. Within-group hearing outcomes were unaffected by cholesteatoma type or tympanoplasty type.

CONCLUSION

The Mercedes-Benz technique may be superior to the ring technique in preventing neodrum retraction. However, the ring graft technique had better hearing outcomes, perhaps due to its more physiological design.