Island cartilage vs temporalis fascia in type 1 tympanoplasty: A prospective study

Introduction Although temporalis fascia is the commonly used graft material for tympanoplasty, cartilage has become the material of choice in cases with eustachian tube dysfunction, bilateral disease, total or anterior perforation of tympanic membrane, tympanosclerosis etc. Cartilage slices < 0.5 mm thick are similar to the tympanic membrane in their acoustic properties. The present study is aimed to describe stitch-less type 1 tympanoplasty with sliced tragal cartilage-perichondrium and evaluate anatomical, audiological and cosmetic outcomes. Materials and Methods A prospective study was conducted from March 2014 to August 2016, in ENT department of a Government Medical College and Hospital, West Bengal, India. Primary tympanoplasty cases irrespective of age, size and site of perforation, laterality and eustachian tube function were included in the study. History of previous tympanoplasty or mastoid surgery and cases requiring ossicular reconstruction or mastoidectomy were excluded from the study. Sliced tragal cartilage-perichondrium graft of 0.2 mm thickness was placed in underlay fashion through trans-canal or end-aural route. Results Among 95 cases 38 were male, 57 were female with age range between 7 to 68 years. Average operative time was 30 minutes. Graft take was successful in 97.89% of cases. Average Air Bone Gap 12 months after operation was 13.03dB. Conclusion Sliced cartilage-perichondrium graft gives good balance between sufficient stability and adequate acoustic sensitivity. Moreover, no stitch technique reduces operative time and increases cosmesis.

Download Full-text

A comparative study of preoperative and postoperative hearing after type I tympanoplasty using temporalis fascia graft at Dr. B. R. Ambedkar Medical College, Bengaluru

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202777 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1258

Author(s):

Muniraju M. ◽

Smita Hegde

Keyword(s):

Disease Duration ◽

Type I ◽

Temporalis Fascia ◽

Hearing Gain ◽

Medical College ◽

Type 1 Tympanoplasty ◽

Fascia Graft ◽

Cortical Mastoidectomy ◽

A Prospective Study

Background: The objective of the study was to identify the factors which significantly influence type 1 tympanoplasty success.Methods: A prospective study was performed on 30 patients who underwent type 1 tympanoplasty via underlay technique using temporalis fascia graft from December 2017 to September 2019 in a teaching hospital. Outcome measures were graft uptake rate and hearing gain. The factors assessed were the age and sex, preoperative condition of the ipsilateral and contralateral ears, perforation size, presence of tympanosclerosis, and whether simultaneous cortical mastoidectomy was performed. Results: None of the factors proved to have a significant influence on tympanic membrane closure or hearing gain.Conclusions: The success rate of a type 1 tympanoplasty is dependent on the skills of the surgeon and the type of graft used. Age, sex, laterality of the disease, duration of dry ear, size of the perforation, presence of tympanosclerosis and simultaneous cortical mastoidectomy have no bearing on hearing gain.

Download Full-text

ROLE OF MASTOIDECTOMY IN TYPE 1 TYMPANOPLASTY OF SAFE TYPE CHRONIC SUPPURATIVE OTITIS MEDIA- A PROSPECTIVE STUDY

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2016/1167 ◽

2016 ◽

Vol 3 (102) ◽

pp. 5645-5649

Author(s):

Sami Ullah ◽

Faiz S. M ◽

Mohd Shakeel ◽

Saurabh Srivastav ◽

Satveer Singh Jassal ◽

...

Keyword(s):

Prospective Study ◽

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

A Prospective Study

Download Full-text

Reinforced temporalis fascia with conchal cartilage versus exclusive temporalis fascia grafting in type 1 tympanoplasty: a comparative study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202779 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1268

Author(s):

Rahul S. Gosavi ◽

Shishir D. Gosavi ◽

Digwijay A. Bandgar ◽

Akash D. Gupta ◽

Pradny S. Naik ◽

...

Keyword(s):

Chronic Otitis Media ◽

Tympanic Membrane Perforation ◽

Temporalis Fascia ◽

Conchal Cartilage ◽

Type 1 Tympanoplasty ◽

Fascia Graft ◽

Membrane Perforation ◽

A Prospective Study ◽

Grafting Materials

Background: Various grafting materials have been used for the repair of a tympanic membrane perforation over the years, with temporalis fascia and conchal cartilage being the most widely used. Our study is an attempt to compare and analyse the use of exclusive temporalis fascia as grafting material against a reinforced graft consisting of temporalis fascia and conchal cartilage.Methods: This is a prospective study of 100 patients having inactive mucosal chronic otitis media with a dry central perforation with moderate conductive hearing loss, undergoing type 1 tympanoplasty using underlay technique. 50% of the subjects were grafted with temporalis fascia alone while a reinforced temporalis fascia graft along with conchal cartilage was used in the remaining 50% of the cases. The results were evaluated at an interval of 24 weeks after surgery on the basis of graft uptake and hearing restoration (closure of air-bone gap <10 dB). Results: Graft uptake in exclusive temporalis fascia grafting was 86% while it was 94% when a reinforced graft was used; the hearing restoration rates in both the groups were 82% and 80% respectively. Conclusions: Reinforced temporalis fascia grafting along with conchal cartilage gives better results than grafting with temporalis fascia alone as regards to graft uptake, while the audiometric results are comparable in both the groups.

Download Full-text

Outcome of Interlay Type 1 Tympanoplasty for Large Central Perforation

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v27i1.53212 ◽

2021 ◽

Vol 27 (1) ◽

pp. 86-91

Author(s):

Md Mahmudul Huq ◽

SM Mostofa Qaiyoum ◽

Md Saifullah Ibne Mannan ◽

Md Kamruzzaman

Keyword(s):

Prospective Study ◽

Uptake Rate ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Effective Technique ◽

Medical College ◽

Type 1 Tympanoplasty ◽

Central Perforation ◽

A Prospective Study

Background: Perforation of the tympanic membrane may occur from various reasons. Most of these perforations heal spontaneously, whereas the remaining long-standing perforations that lead to recurrent ear discharge need tympanoplasty. Interlay Type 1 Tympanoplasty,a newer technique has shown promising results with higher success ratein terms of hearing gain and graft uptake. Objective: To analyze the results of interlay Type 1 Tympanoplasty in terms of graft uptake and hearing improvement in cases of inactive mucosal chronic otitis media (COM) with large central perforation. Methods: This is a prospective study of 24 months (January 2018 to December 2019) duration conducted in department of E.N.T, Khulna medical college, Khulna and data was collected from the 60 patients admitted for tympanoplasty. Results were calculated in terms of graft accepted or rejected and decrease in air bone gap. Result: The graft uptake rate in the present study was found to be 91.67% and the patients reported an improvement in terms of hearing. Pre operatively mean air bone gap was 26.5dBand post operatively after 12 weeks mean air bone gap improved to 17.58dB. Conclusion: Interlay Type 1 Tympanoplasty is an effective technique over conventional methods in terms of both graft uptake as well as hearing improvement in large central perforation. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 86-91

Download Full-text