{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:45:38Z","timestamp":1782449138645,"version":"3.54.5"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>To our knowledge, this represents the first adult-only, fully endoscopic, three-arm comparative cohort of autograft, allograft, and xenograft materials in type I tympanoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare graft-take, audiometric outcomes, operative time, and complications among perichondrium, MegaDerm, and Biodesign in adult endoscopic type I tympanoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective comparative cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Adults who underwent endoscopic type I tympanoplasty with perichondrium, MegaDerm or Biodesign between October 2021 and March 2025. Patients with revision surgery, concomitant otologic procedures, active middle-ear disease, profound sensorineural hearing loss, preoperative air-bone gap (ABG) \u226550\u2009dB, or follow-up &lt;3\u2009months were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention or Exposures<\/jats:title>\n                    <jats:p>Endoscopic type I tympanoplasty using perichondrium (autograft), MegaDerm (allograft), or Biodesign (xenograft).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Graft-take rate, hearing gain (air-conduction and ABG), operative time, and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety-three ears were analyzed (perichondrium n\u2009=\u200933; MegaDerm n\u2009=\u200921; Biodesign n\u2009=\u200939). Three-month graft-take rates were similar, and final graft-take rates remained comparable across groups (3\u2009months: 90.9%, 90.5%, 94.9%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.6862; final: 84.8%, 85.7%, 84.6%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.999). Air-conduction (AC) and ABG improved significantly within all groups. Between-group differences were not significant for AC gain (13.79\u2009\u00b1\u20099.84 vs 7.24\u2009\u00b1\u200912.46 vs 9.14\u2009\u00b1\u200910.01\u2009dB;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0804) or ABG gain (9.58\u2009\u00b1\u200910.46 vs 8.82\u2009\u00b1\u200910.37 vs 7.58\u2009\u00b1\u20098.46\u2009dB;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.7757); the proportion achieving postoperative ABG \u226420\u2009dB was similar (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.475). Operative time was significantly longer for perichondrium (98.23\u2009\u00b1\u200932.35, 68.52\u2009\u00b1\u200920.84, and 74.88\u2009\u00b1\u200917.27;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Complications were infrequent (otomycosis, n\u2009=\u20093; myringitis, n\u2009=\u20091), and no facial palsy, intractable vertigo, profound sensorineural hearing loss(SNHL), or dysgeusia occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In adult endoscopic type I tympanoplasty, perichondrium, MegaDerm, and Biodesign demonstrated comparable short-term graft-take and audiometric outcomes, while commercially available grafts were associated with shorter operative time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance:<\/jats:title>\n                    <jats:p>These findings support patient-centered graft selection balancing donor-site considerations, operative efficiency, and cost; prospective studies with standardized follow-up and patient-reported outcomes are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216261454991","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:50:28Z","timestamp":1782211828000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Type I Tympanoplasty: Comparative Outcomes of Autograft, Allograft, and Xenograft"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3764-8630","authenticated-orcid":false,"given":"Yi-Chen","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan"},{"name":"School of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Yu","family":"Hu","sequence":"additional","affiliation":[{"name":"School of Medicine, Chang Gung University, Taoyuan, Taiwan"},{"name":"Division of Otology, Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan"},{"name":"Department of Otorhinolaryngology &amp; Head and Neck Surgery, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bang-Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology &amp; Head and Neck Surgery, Fu Jen Catholic University Hospital, New Taipei City, Taiwan"},{"name":"School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2455-2170","authenticated-orcid":false,"given":"Kuan-Ting","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Chang Gung 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