Use of AlloDerm in type I tympanoplasty: a comparison with native tissue grafts.

Objectives: AlloDerm, an acellular human dermis allograft, has been shown to be an effective option as a tympanic membrane (TM) graft in animals and humans and has several potential advantages, including eliminating donor site morbidity, reducing operative time, and preserving native tissues for later use. We compared AlloDerm and native tissue grafts in type I tympanoplasty with regard to operative time, graft success rate, and audiologic outcome.

Study Design: A retrospective chart review of tympanoplasties performed at a major tertiary referral hospital over a 31 month period, starting with the first use of AlloDerm for TM grafting at this institution.

Methods: The medical charts of all patients undergoing tympanoplasty were reviewed. Only those patients undergoing type I tympanoplasty without mastoidectomy or ossicular chain reconstruction were included. These 114 patients (25 AlloDerm, 56 fascia reconstruction, and 33 fascia plus cartilage reconstruction) were compared for operative time, success rate of the graft, and change in audiologic outcome.

Results: There was a statistically significant reduction in operative time in the AlloDerm group when controlled for surgeon and choice of approach. All groups showed no statistically significant difference in the success rate of the graft and closure of audiologic air-bone gap, regardless of graft material used.

Conclusions: AlloDerm is an effective TM graft when used in type I tympanoplasty. It is as effective as native tissues in closing the air-bone gap on audiogram as well as in graft success rate. AlloDerm may also significantly reduce operative time, depending on the surgeon's technique.