Temporalis fascia grafts shrink

1997 ◽  
Vol 111 (8) ◽  
pp. 707-708 ◽  
Author(s):  
R. J. England ◽  
D. R. Strachan ◽  
J. G. Buckley
Keyword(s):  
Tympanic Membrane ◽  
Graft Failure ◽  
Saline Solution ◽  
Failure Rates ◽  
Temporalis Fascia ◽  
Tympanic Membrane Perforations ◽  
Cent Saline ◽  
Dry Out ◽  
Graft Shrinkage

AbstractTemporalis fascia, placed as an underlay graft, is commonly used to repair tympanic membrane perforations. Graft failure, however, is a well recognized complication. Grafts are often allowed to dry out during the procedure and, therefore, are often positioned in a dry or partially dehydrated state and only become fully rehydrated after placement. This study looked at how the size of the temporalis fascia alters with its state of hydration. The size of 20 temporalis fascia grafts was measured when fresh, after flattening and allowing them to dry, and finally after rehydrating the grafts with 0.9 per cent saline solution. Significant shrinkage was demonstrated. It is therefore proposed that a cause of increased failure rates, particularly in anterior myringoplasties, is loss of underlay due to graft rehydration and shrinkage. Thus graft shrinkage should be considered when positioning the graft.

Results of inlay cartilage myringoplasty in terms of closure of central tympanic membrane perforations

2005 ◽  
Vol 119 (8) ◽  
pp. 611-613 ◽  
Author(s):  
Kamal G Effat
Keyword(s):  
Retrospective Study ◽  
Tympanic Membrane ◽  
Control Group ◽  
Temporalis Fascia ◽  
Current Effort ◽  
Hospital Records ◽  
Tympanic Membrane Perforations ◽  
The Difference ◽  
A Current

There is a current effort to perform myringoplasty for tympanic membrane perforations as a day-stay procedure. In 1998, an inlay myringoplasty using tragal cartilage/perichondrium was described. A retrospective study was performed by the author to analyse the results of inlay carilage myringoplasty, in terms of closure of simple perforations of the tympanic membrane. The results of a control group of previous cases of underlay temporalis fascia myringoplasty were retrieved from the hospital records. All the operations in both groups were performed by the same author at the same institution. The operation of inlay cartilage butterfly myringoplasty has been performed in 28 ears with simple central tympanic membrane perforations. Inconsistent results have been obtained, in that only 43 per cent showed closure of the perforation at the most recent follow-up. A control group of standard underlay temporalis fascia myringoplasty has been performed by the same author in 23 ears. Eighty-three per cent of the perforations were closed at the last follow-up. The difference is statistically highly significant (p < 0.01).

Composite chondro-perichondrial clip myringoplasty: our experience

2016 ◽  
Vol 2 (4) ◽  
pp. 249
Author(s):  
Shrikrishna B. H. ◽  
Jyothi A. C.
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Canal Wall ◽  
Inclusion Criteria ◽  
Temporalis Fascia ◽  
Tympanic Membrane Perforations ◽  
Complete Closure ◽  
External Canal ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">There are several studies on the efficacy of the commonly used temporalis fascia for myringoplasty where the temporalis fascia is placed by underlay method after incising external canal wall skin. This study was conducted assess the success rate and efficacy of use of a composite chondro-perichondrial graft in a combined overlay-underlay fashion where the external canal wall is not incised. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study was conducted where 30 cases of non-marginal perforation of tympanic membrane were properly selected based on the inclusion criteria. All the 30 cases underwent myringoplasty using composite chondro-perichondrial graft harvested from tragal cartilage and placed in a combined overlay-underlay fashion.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">There was complete closure of the perforation in 27 of the total 30 cases. Also there was reduction in the air-bone gap post-operatively in all the 27 cases with complete closure of the tympanic membrane perforations. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Composite chondro-perichondrial clip myringoplasty is an effective method of closing non-marginal perforations of the tympanic membrane.</span></p>

Fat graft myringoplasty: a cost-effective but underused procedure

2005 ◽  
Vol 119 (4) ◽  
pp. 277-279 ◽  
Author(s):  
O B Ozgursoy ◽  
I Yorulmaz
Keyword(s):  
Clinical Trial ◽  
Adipose Tissue ◽  
Tympanic Membrane ◽  
Cost Effective ◽  
Fat Graft ◽  
Temporalis Fascia ◽  
Tympanic Membrane Perforations ◽  
Cost Effective Alternative ◽  
One Year

Objectives: The objective of this study was to evaluate the success of fat graft myringoplasty and to discuss the utilities and advantages of a fat graft in primary versus revision myringoplasties.Methods: Eighteen patients who had not had previous otological surgery, and twelve patients whose tympanic membrane perforations have persisted despite myringoplasty with temporalis fascia were included in this prospective clinical trial. All patients were treated by fat graft myringoplasty and followed up for one year.Results: Successful closure of the perforation was obtained in 82.4 per cent of the ears at the final follow up. The success rate in the group of patients who had not had previous otological surgery was higher than those of revision cases.Conclusions: Adipose tissue provides the basic requirements for grafting of the tympanic membrane, with its own favourable characteristics. Fat graft myringoplasty is a cost-effective alternative in small perforations of the tympanic membrane, including revision cases.

Observations of Middle Ear Pressures

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 56-60 ◽  
Author(s):  
Richard A. Buckingham ◽  
Jose L. Ferrer
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Motion Picture ◽  
Saline Solution ◽  
Positive Pressure ◽  
Motion Picture Film ◽  
Sterile Saline ◽  
Tympanic Membrane Perforations ◽  
Middle Ear Pressure ◽  
Direct Measurements

Previous direct measurements of middle ear pressure in ears with serous otitis resulted in the range of from 0 to − 10 mm H2O pressure. To confirm these findings we attempted to quantify middle ear pressures by doing myringotomies in serous otitis patients through sterile saline solution. We compared the rate of aspiration of the saline in ears with serous otitis to the rate of aspiration of saline after an experimental myringotomy in an ear model in which known pressures were imposed. To record our findings we used motion picture photography. Layering a film of sterile oil suspension of oxytetracycline and hydrocortisone over dry tympanic membrane perforations resulted in the demonstration of a pulsatile positive pressure of about 6 mm water in many of the ears which we tested. The oil film often formed an external bubble which ruptured after several minutes. In some ears there was no change in pressure and in only a small percentage there was evidence of a decreased pressure by absorption of air in the middle ear during the period of observation. This positive pressure is unrelated to swallowing and suggests that the current theories of middle ear aeration via opening of the eustachian tube may not be valid. These findings were demonstrated with motion picture film.

scholarly journals A comparative study between fat myringoplasty and temporalis fascia tympanoplasty in moderate to large central perforation of pars tensa of tympanic membrane

2017 ◽  
Vol 3 (4) ◽  
pp. 997
Author(s):  
Kirti P. Ambani ◽  
Rachana W. Gangwani ◽  
Bhavya B. M. ◽  
Sanket D. Vakharia ◽  
Ashish U. Katarkar
Keyword(s):  
Tympanic Membrane ◽  
Postoperative Infection ◽  
Bone Conduction ◽  
Fat Graft ◽  
Graft Material ◽  
Temporalis Fascia ◽  
Membrane Repair ◽  
Tympanic Membrane Perforations ◽  
Fascia Graft ◽  
Group 2

<p class="abstract"><strong>Background:</strong> To compare the efficacy between fat graft (FG) and temporalis fascia (TF) graft in tympanic membrane perforations larger than 4mm size or involvement of &gt;25% of tympanic membrane.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out during December 2015 to January 2016, for a period of 13months at our Otolaryngology Department. All study patients, who fit into inclusion and exclusion criteria, were divided into two groups according to the type of graft material taken. In group- 1temporalis fascia (TF) graft was taken while in group- 2 fat graft (FG) was taken. An evaluation of hearing was done with full Audiometric and Eustaschian tube function testing. All laboratory preoperative testing was done. Postoperative follow up was done at 2<sup>nd</sup>, 3<sup>rd</sup> and 5<sup>th</sup> month’s period and sos, graft status and hearing evaluation with PTA for all four frequencies 500, 1000, 2000 and 4000 Hz with air conduction and bone conduction thresholds were recorded and compared with preoperative PTA records in both groups.  </p><p class="abstract"><strong>Results:</strong> In TF group total 24 (80%) patients had graft uptake, 4 (13.3%) patients had residual perforation and 2 (6.6%) patients had graft failure due to postoperative infection. In FG group total 16 (53.3%) patients had graft uptake, 6 (20%) patients had graft medialised and necrosed, 6 (20%) patients had residual perforation and 2 (6.6%) patient had graft rejection due to postoperative infection. Graft uptake rate in group 1 was 80% while in group 2 was 53.3%. Mean preoperative ABG in TF group was 25±17 dB and mean postoperative ABG was 10±02 dB, in fat graft technique mean preoperative ABG was 25±13 dB and mean postoperative ABG was 16±15 dB. Fat graft technique is simple, quick and minimally invasive. It doesn’t require middle ear manipulation.</p><p><strong>Conclusions:</strong> There is no ideal material for tympanic membrane repair but for moderate to large perforation temporalis fascia graft is better than fat graft in terms of healing and hearing outcomes but considering morbidity fat gives less morbidity. </p>

Adipose Plug Myringoplasty: An Alternative to Formal Myringoplasty Techniques in Children

1989 ◽  
Vol 101 (6) ◽  
pp. 617-620 ◽  
Author(s):  
Charles W. Gross ◽  
Mahan Bassila ◽  
Rande H. Lazar ◽  
Thomas E. Long ◽  
Shirley Stagner
Keyword(s):  
Tympanic Membrane ◽  
Operative Technique ◽  
Cost Effective ◽  
Temporalis Fascia ◽  
Effective Technique ◽  
Tympanic Membrane Perforations ◽  
Cost Effective Technique ◽  
Criteria For Selection

Adipose myringoplasty is presented as a simple and cost-effective technique in managing small tympanic membrane perforations in children. A review of 76 fat plug myringoplasties performed on 62 children with drum perforations over a 15-year period was done. Fifty-nine myringoplasties were postinflammatory and/or after extrusion of pressure-equalizing (PE) tubes. Sixteen were residual perforations following temporalis fascia tympanoplasty, and one was posttraumatic perforation. Criteria for selection, operative technique, and results are discussed.

Traction Suture Tympanoplasty

1988 ◽  
Vol 98 (4) ◽  
pp. 291-294 ◽  
Author(s):  
George C. Swanson
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Great Distance ◽  
Canal Wall ◽  
Temporalis Fascia ◽  
Tympanic Membrane Perforations ◽  
Fascia Graft ◽  
Medical Facilities ◽  
Traction Suture ◽  
Anterior Canal

Subtotal tympanic membrane perforations are very common in Micronesia. The great distance between the islands, primitive conditions, and shortages of medical facilities and supplies must all be considered when a technique is designed for the closure of these perforations. Such a technique, using dissolvable sutures to position and support a medial temporalis fascia graft, is presented. A suture is used to place traction on the graft to assure proper placement under the anterior remnant or anterior canal wall skin. The graft is placed medial to the remnant but lateral to the malleus handle, which has been carefully dissected free of epithelium. Two hundred eighty-one cases were followed for' 6 months or more, with a success rate of slightly more than ninety-five percent. Complications of blunting, lateralization, reperforation of the graft, and cholesteatoma formation are discussed.

scholarly journals Comparative study between fascia lata and temporalis fascia in myringoplasty

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ayman Ali Abdel Fattah ◽  
Abdel Hay Rashad Elasy ◽  
Ahmed Helmy Hoseini ◽  
Tarek Abdel Rahman Abdel Hafez
Keyword(s):  
Tympanic Membrane ◽  
Good Alternative ◽  
Fascia Lata ◽  
The Body ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Fascia Lata Graft ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation. Results A total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B. Conclusion Using temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.

Sign in / Sign up

Export Citation Format

Share Document