Endoscopic myringoplasty in pediatric patients: a comparison of cartilage graft push-through and underlay fascia graft techniques

Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge and perforation. It is the commonest ear problem in adult and children. Most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. Inactive mucosal variety of COM presents with the perforation in tympanic membrane with non-inflamed middle ear mucosa. The treatment of inactive mucosal variety of COM is Type 1tympanoplasty. It can be done by conventional temporalis fascia or cartilage graft. Both have some merits and demerits. Objective: To compare the the outcomes between reinforcement cartilage graft and temporalis fascia graft in type -1 tympanoplasty. Methods: 86 (43 patients in each group) patients with COM (inactive mucosal) who were admitted in the department of Otolaryngology – Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2018 to June 2019, and had fulfilled the inclusion and exclusion criteria were selected for the study. History, examinations, investigations were done. All patients underwent type 1 tympanoplasty. Prior to surgery relevant investigations were done and informed written consent was taken from all patients. In Group-A reinforcement cartilage tympanoplasty cases and in Group-B temporalis fascia tympanoplasty cases were placed. Post-operative graft uptake rate and hearing gain were compared in two groups Results: The surgical outcomes between reinforcement cartilage tympanoplasty in comparison with temporalis fascia tympanoplasty showed no significant difference of graft uptake rate and hearing gain. Conclusion: Cartilage tympanoplasty has been practised for reconstruction of perforated tympanic membrane in COM since long with variable results. Graft uptake rate in cartilage reinforcement is comparatively better than temporalis fascia graft. So, reinforcement cartilage graft can be adopted as an alternative to temporalis fascia graft in type- I tympanoplasty. Bangladesh J Otorhinolaryngol 2021; 27(2): 104-110

Download Full-text

A Comparative Study of Temporalis Fascia Graft and Full Thickness Tragal Island Cartilage Graft in Type 1 Tympanoplasty

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-021-02459-2 ◽

2021 ◽

Author(s):

Deepakraj Venkatesan ◽

Preethi Umamaheswaran ◽

Ramkumar Vellikkannu ◽

Senthil Kannan ◽

Alagammai Sivaraman ◽

...

Keyword(s):

Comparative Study ◽

Cartilage Graft ◽

Full Thickness ◽

Temporalis Fascia ◽

Type 1 Tympanoplasty ◽

Fascia Graft

Download Full-text

A COMPARATIVE STUDY OF TYMPANOPLASTY USING SLICED CARTILAGE GRAFT VS. TEMPORALIS FASCIA GRAFT

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2018/116 ◽

2018 ◽

Vol 5 (7) ◽

pp. 566-569

Author(s):

Rahul Ashok Telang ◽

Samir Vinayak Joshi ◽

Jithesh A.S

Keyword(s):

Comparative Study ◽

Cartilage Graft ◽

Temporalis Fascia ◽

Fascia Graft

Download Full-text

COMPARATIVE STUDY ON BILATERAL SINGLE SITTING ENDOSCOPIC MYRINGOPLASTY CONCHAL CARTILAGE VERSUS TEMPORALIS FASCIA GRAFT

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2017/985 ◽

2017 ◽

Vol 4 (84) ◽

pp. 4941-4944

Author(s):

Indra Thirugnanam ◽

Rajasekar M.K

Keyword(s):

Comparative Study ◽

Temporalis Fascia ◽

Conchal Cartilage ◽

Fascia Graft ◽

Endoscopic Myringoplasty

Download Full-text

A comparative study of endoscopic and microscopic myringoplasty in a rural tertiary care teaching hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200144 ◽

2020 ◽

Vol 6 (2) ◽

pp. 321

Author(s):

Viswanathan Kavathur ◽

Vineeth Abraham Anchery

Keyword(s):

Tympanic Membrane ◽

Statistical Significance ◽

Tertiary Care ◽

Routine Activity ◽

P Value ◽

Failure Rates ◽

Success Rates ◽

Fascia Graft ◽

Significant Difference ◽

Endoscopic Myringoplasty

Background: Myringoplasty is the procedure done to repair the tympanic membrane perforation. In this study we aimed to compare the results of endoscopic myringoplasty and microscopic tympanoplasty.Methods: A total of 50 patients with central perforation of tympanic membrane and dry ear of minimum 6 months were divided into two groups of 25 each. The even serial numbers were subjected to microscopic myringoplasty through post aural route and odd serial numbers were subjected to endoscopic myringoplasty done through endomeatal route. Both the procedures were done under general anaesthesia. Dried temporalis fascia graft was used and follow up till 1 year post op. Air-bone gap closure, average time taken for surgery, success and failure rates, scar evaluation by doctor and patient along with postoperative return to routine activity were compared. The p value was calculated to find out statistical significance. Results: Post operatively the average air-bone gap reduced to 12.6 dB in endoscopic group and 14.28 dB in microscopic group. There was no statistical significant difference in the time taken for both the procedures. There was significant difference in the assessment of postoperative scar and number of days taken for return to routine activity. The success and failure rates of both the procedures were also found to be comparable.Conclusions: Our study showed that the success rates and average time taken for the procedures were the same for both the techniques but a better cosmetic appeal and considerably fewer days for return to routine activity by the patients who underwent endoscopic procedure.

Download Full-text

COMPARATIVE STUDY OF TYMPANOPLASTY WITH CONVENTIONAL TEMPORALIS FASCIA GRAFT VERSUS TRAGAL CARTILAGE PERICHONDRIUM GRAFT

10.36106/ijsr/2100918 ◽

2020 ◽

pp. 1-4

Author(s):

Apurba Sarkar ◽

Debabrata Das ◽

Anurag Pradhan ◽

Sk Nawazur Rahaman ◽

arjuman Parveen

Keyword(s):

Success Rate ◽

Failure Rate ◽

Surgical Outcome ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Composite Graft ◽

Cartilage Graft ◽

Temporalis Fascia ◽

Fascia Graft ◽

The Mean

The study was carried out on 50 patients with central perforation in tympanic membrane ( dry & inactive stage ). The study was done in the department of OTORHINOLARYNGOLOGYof BURDWAN MEDICALCOLLEGE AND HOSPITALover a period of one year. The study was done on comparison between tympanoplasty procedure using temporalis fascia as graft versus cartilage composite graft. Precise history was taken from respective patients in detail and were examined clinically. Patients with dry perforation with good cochlear reserve, intact and mobile ossicular chain, functioning Eustachian tube were selected randomly for the operation. Tympanoplasty procedure using temporalis fascia as graft was done in 50% (n=25) patients and tympanoplasty procedure using cartilage composite graft was done in 50% (n=25) patients. In this study the age range of patients were from 13 to 50 years, the mean age was 26.62 years, the number of male and female was equal. Right sided disease was predominant in our study and the mean duration of symptom was 11.24 months. The mean pre-operative hearing loss (pure tone average by pure tone audiometry) was 37.84 ± 4.65 dB and mean pre operative airbone gap was 22.84 ± 4.65 dB . Post operative Mean air conduction was 23.48 ± 5.54 dB among them 24.2 ± 6.26 dB in the fascial group and 22.76 ± 4.73 dB in the cartilage group. This result is not statistically signicant. Post operative mean air-bone gap was 13.84 ± 5.94 dB among them 14.76 ± 5.6 dB in fascial group and 12.92 ± 6.23 dB in the cartilage group which is not signicant stastistically. Successful graft take-up rate of 88.00% (n=44). The overall success rate among tympanoplasty using temporalis fascia graft( GROUP A ) and tympanoplasty using composite cartilage graft ( GROUP B ) technique were 84.00% (n=21) and 92.00% (n=23) respectively. 12.00% (n=6) patients were marked as failure cases during postoperative follow up period. The overall failure rate among tympanoplasty using temporalis fascia graft( GROUPA) and tympanoplasty using composite cartilage graft ( GROUPB ) technique were 16.00% (n=4) and 8.00% (n=2) respectively. So the distribution of surgical outcome in terms of success rate or failure rate was statistically insignicant in the two study groups (p= 0.384). So the distribution of surgical outcome in terms of success rate or failure rate cartilage composite graft gives a denitely better result than temporalis fascia graft. However, the two method did not differ signicantly in terms of hearing improvement.

Download Full-text

Myringoplasty With an Ultrathin Cartilage-Perichondrium Complex Graft Versus Temporalis Fascia Graft: A Propensity Score–Matched Analysis

Otolaryngology ◽

10.1177/0194599820965940 ◽

2020 ◽

pp. 019459982096594

Author(s):

Yi-Bo Huang ◽

Lu-lu Hu ◽

Dong-Dong Ren ◽

Zhao Han

Keyword(s):

Propensity Score ◽

Middle Ear ◽

Test Group ◽

Control Group ◽

Temporalis Fascia ◽

Closure Rate ◽

Factors Affecting ◽

Fascia Graft ◽

Endoscopic Myringoplasty ◽

Air Conduction

Objective To compare endoscopic myringoplasty using the cartilage-perichondrium complex as a graft (test group) with temporalis fascia microscopic myringoplasty (control group). Study Design A retrospective cohort study. Setting Department of Otorhinolaryngology in a tertiary Chinese hospital. Methods Data were collected on patients between 2017 and 2019. To balance the baseline characteristics between groups, we performed a propensity score–matched analysis, and 44 patients were included in each group. Hearing improvement and eardrum closure rates were compared, and risk factors affecting them were analyzed. Results In the control and test groups, 90.90% and 86.36% of patients had a mean air-bone gap ≤20 dB after the surgery, respectively ( P = .843). The air conduction (AC) threshold gain at each frequency was similar in the 2 groups ( P > .05). The closure rates were 95.45% and 93.18%, respectively ( P = .645). The air-bone gap improved significantly after surgery, F(1, 61) = 6.729, P = .012. Age, group, middle ear mucosal status, and location of the perforation did not affect the change in air-bone gap or the drum closure rate ( P > .05). However, there was an interaction between the change in air-bone gap and the size of the perforation, F(1, 61) = 11.067, P = 0001. Conclusion Endoscopic myringoplasty using a cartilage-perichondrium complex graft is comparable with traditional surgery. Age, location of the perforation, and middle ear mucosal status did not significantly affect the change in air-bone gap or the drum closure rate. A perforation size ≥50% was always associated with a better air-bone gap improvement.

Download Full-text