Type 1 pediatric tympanoplasties using fascia and cartilage grafts.

Here, we present a review of the article entitled ‘‘Comparison of temporalis fascia muscle and full-thickness cartilage grafts in type 1 pediatric tympanoplasties’’ by Yegin et al.1 The work described in their paper was interesting. Cartilage grafts improved the long-term success rate of tympanoplasties versus temporalis fascia grafts in tympanoplasties due to Eustachian tube dysfunction in children. However, the study design and short follow-up weakened their conclusions. The authors stated that ‘‘A retrospective review of data collected from January 2013 to September 2014 was performed at our hospital’’ and ‘‘The patients were randomly allocated to surgery using temporalis fascia muscle or tragal cartilage grafts by the surgeons’’ in their Methods.1 We believed that a ‘‘retrospective review’’ and ‘‘randomly allocated’’ are contradictory. Randomized control cannot be performed in a retrospective study. Randomized controlled trials, considered the gold standard of study design, are prospective studies. They can provide evidence of causeand-effect relationships and support changes in clinical practice or workplace interventions. In a randomized controlled trial, subjects are randomly assigned to receive the intervention or control treatment, and outcomes are evaluated after the intervention period. The control group is the group that receives standard care, no intervention, or a placebo. If the patients were not randomized, the results might include some bias. Thus, we believe that the study needs to be a prospective study, with random control, a larger sample size, and longer follow-up to reach valid conclusions.