Comparative study of graft materials used in myringoplasty

Background: Various graft materials are used for myringoplasty in practice. Present study was done to compare the hearing improvement and graft uptake rate in patients with inactive mucosal type chronic otitis media with central perforation undergoing myringoplasty using either of the two graft materials: temporalis fascia and conchal perichondrium.Methods: Patients with tubotympanic type of chronic suppurative otitis media were selected from patients attending the ENT OPD of SMGS Hospital, Government Medical College, Jammu between July 2016 to March 2018. This study included 100 patients out of which 50 were subjected to myringoplasty with temporalis fascia grafting (Group 1) and remaining 50 to conchal perichondrium grafting (Group 2) using underlay technique. The comparative study was done on following parameters-graft uptake and audiological outcome. Results: 82% patients were of age less than 30 years. The overall male: female ratio was 1.3:1. In Group 1, 76% had gain of 15 db while 12% had gain of >15 db. In Group 2, 72% had gain of 15 db and 8% had gain of >15 db. The graft was intact in 84% patients. 12% of Group 1 patients, showed residual perforation whereas it was 20% in Group 2 patients.Conclusions: The study showed that: the temporalis fascia graft is better than conchal perichondrial graft for closure of perforations in inactive mucosal type of chronic otitis media with central perforation because of maximum hearing improvement and minimal failure rate in group receiving temporalis fascia graft.

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A Prospective Comparative Study between Dry and Wet Tympanoplasty

Annals of Otology and Neurotology ◽

10.1055/s-0038-1676951 ◽

2018 ◽

Vol 01 (02) ◽

pp. 083-088 ◽

Cited By ~ 1

Author(s):

Hepsiba Pothala ◽

Sunita Shukla ◽

Wasim Khan ◽

Ravi Ramalingam ◽

Kombupalayam Ramalingam

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Uptake Rate ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Significant Difference ◽

Prospective Comparative Study ◽

Contralateral Ear

Abstract Background Tympanoplasty is the well-established procedure for closure of perforations of tympanic membrane. Study Design This study was a prospective comparative study. Objective The objective of this study was to compare the hearing improvement and graft uptake rate between dry and wet tympanoplasty performed on tubotympanic type of chronic suppurative otitis media. Materials and Methods One hundred forty patients with tubotympanic type of chronic otitis media were selected and categorized into dry and wet ears. Tympanoplasty was performed using temporalis fascia by underlay technique in all cases. Postoperatively, graft uptake rate and hearing improvement were analyzed. Results The graft uptake rate was equal in both dry and wet ears, which was statistically insignificant. There was no statistically significant difference in the hearing improvement between the dry ears and wet ears (χ – 2.39, p = 0.122). Conclusion Factors such as age, sex, and status of the contralateral ear and wet ear did not have any impact on the postoperative graft uptake of tympanoplasty. There was no difference in the graft uptake between the dry and wet ears and there was no statistically significant difference between hearing improvement in both and wet ears.

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A comparative study of post-operative outcomes in type 1 tympanoplasty using tragal chondroperichondrial shield graft and temporalis fascia graft

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201676 ◽

2020 ◽

Vol 6 (5) ◽

pp. 867

Author(s):

Pradeep Kumar Muniasamy ◽

Dharanya Gopalakrishnan Srinivasan ◽

Prabu Velayutham ◽

Nishanth Savery ◽

Balasubramanian Krishnaswami ◽

...

Keyword(s):

Comparative Study ◽

Uptake Rate ◽

P Value ◽

Age Group ◽

Temporalis Fascia ◽

Type 1 Tympanoplasty ◽

Fascia Graft ◽

Group 2 ◽

Group 1

Background: Type 1 tympanoplasty is the reconstruction of perforated tympanic membrane with an intact and mobile ossicular chain. Among various autologous graft materials, temporalis fascia and tragal chondroperichondrium are commonly used, having their own merits and demerits. In our study, we have compared the results and postoperative outcomes of tympanoplasty using temporalis fascia and tragal chondroperichondrium.Methods: This prospective comparative study included 60 cases of chronic suppurative otitis media - tubotympanic disease (CSOM-TTD) in a tertiary care centre. They were randomised into two groups of 30 patients each and were subjected to tympanoplasty using either tragal cartilage-perichondrium (group 1) or temporalis fascia graft (group 2) from November 2017 to May 2019. Objective hearing improvement at 1st, 3rd and 6th month postoperative follow-up and graft uptake rate at 3rd month were compared. Results: Incidence of cases was more in the age group between 31-45 years age group (53.3%). Graft uptake rate was 96.6% for temporalis fascia group and 83.33% for tragal group (p value - 0.194). Preoperative air-bone (AB) gap in group 1 was found to be 25±4.09 dB which improved to 11.73±2.21 dB at 6 months and in group 2, it was 25.7±3.94 dB which improved to 14.06±3.68 dB at 6 months. Mean improvement in hearing for tragal group (13.27 dB) was better than temporalis fascia group (11.64 dB) (p value <0.001).Conclusions: Both temporalis fascia and tragal chondroperichondrium are suitable graft materials for tympanoplasty, although graft uptake was clinically better with the use of temporalis fascia.

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Benefit of Tympanoplasty with or without Cortical Mastoidectomy in Active Mucosal Otitis Media – A Comparative Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2019.v27i1.229 ◽

2019 ◽

Vol 27 (1) ◽

Author(s):

Anushree Raviprakash Bajaj ◽

Shahnaz Sheikh ◽

Samir Joshi ◽

Bhalchandra Paike

Keyword(s):

Otitis Media ◽

Hearing Threshold ◽

Chronic Otitis Media ◽

Research Articles ◽

Hearing Improvement ◽

Post Operative Period ◽

Cortical Mastoidectomy ◽

Significant Difference ◽

Group 2 ◽

Group 1

Introduction: Chronic otitis media (COM) is amongst the most common diseases treated by ENT surgeons in India. It has been advocated in lot of research articles that there is no significant difference in tympanoplasty done in active and inactive COM. The objective was to see if cortical mastoidectomy in cases of active mucosal COM, improves the success rate of tympanoplasty measured as per the following parameters: improvement in the hearing threshold by 15 dB, increased graft uptake and reduction in retraction of tympanic membrane in post operative period. Materials and Methods: This study comprises of 120 patients coming to the ENT OPD from October 2016 to October 2017 with active mucosal COM with central perforation requiring tympanoplasty. These patients were randomly assigned to two groups: Group 1 of 60 subjects in which tympanoplasty without mastoidectomy was done, Group 2 of 60 subjects in which tympanoplasty with mastoidectomy was done. Patients were evaluated after a post operative period of 3 months. Results: The Results were the hearing improvement was 73.33% in group 1 while 83.33% in group 2, graft uptake was 63.33% in group 1 and 80% in group 2, graft retraction was 33.33% and 23.33% in group 1 and group 2 respectively. Conclusion: There was statistically significant difference in results in group with and without mastoidectomy in active mucosal chronic otitis media with respect to graft uptake and improved hearing.

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Comparison of efficacy of myringoplasty in dry and wet ears in chronic otitis media of tubotympanic type

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173051 ◽

2017 ◽

Vol 3 (3) ◽

pp. 705 ◽

Cited By ~ 1

Author(s):

Yogeshwar Chandrashekar ◽

Ravishankar Chandrashekar

Keyword(s):

Otitis Media ◽

Statistical Significance ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Inflammatory Cells ◽

P Value ◽

Hearing Improvement ◽

Female Ratio ◽

Fascia Graft ◽

A Prospective Study

Background: The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.Methods: This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively. Results: Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688>0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582>0.05).Conclusions: The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement.

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TO ASSESS THE OUTCOME OF ENDOSCOPIC INTERLAY TYMPANOPLASTY IN TERTIARY CARE CENTER

10.36106/ijsr/5114125 ◽

2021 ◽

pp. 73-75

Author(s):

Pasunuti Shravya ◽

Jyothi Swarup ◽

Vigeshwar RK

Keyword(s):

Success Rate ◽

Otitis Media ◽

Care Center ◽

Tertiary Care ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Conducting Mechanism ◽

Conductive Hearing ◽

Middle Ear Cleft

Background: Chronic otitis media is an inammatory process in middle ear cleft which is treated by a common otological procedure tympanoplasty to reconstruct the tympanic membrane and to restore sound-conducting mechanism. Rigid endoscope in transcanal interlay tympanoplasty has signicant advantage as it provides magnied, and wide angle view, with better success rate and postoperative hearing gain. The Aims and objectives were to assess the outcome of endoscopic interlay tympanoplasty, in terms of graft uptake, hearing improvement and rate of complications in cases of inactive mucosal chronic suppurative otitis media. Methods: This prospective study was conducted for 1 year at our institution in 50 patients having conductive hearing loss with dry, central perforation. All patients underwent transcanal endoscopic interlay tympanoplasty and were followed up for 3months to determine the graft uptake, hearing improvement and rate of complications. Results: Graft uptake rate in the present study was found to be 98% with residual perforation as a complication in 2% patients and no other complications were encountered. Post operatively air bone gap (ABG) after 12 weeks found to be < 20 dB ABG in 84% patients. Conclusion: Endoscopic interlay tympanoplasty is a effective method with high success rate both in terms of graft uptake as well as post operative hearing improvement and can be implemented in all cases of inactive mucosal COM.

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A Comparative Study on Morphological and Audiological Outcome in Type Ι Tympanoplasty for Chronic Otitis Media Mucosal Disease Using Temporalis Fascia versus Cartilage Graft

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v7i11.136 ◽

2019 ◽

Vol 7 (11) ◽

Author(s):

Amrutha P Raman ◽

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Chronic Otitis Media ◽

Cartilage Graft ◽

Temporalis Fascia ◽

Mucosal Disease

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Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: is it routinely necessary?

The Journal of Laryngology & Otology ◽

10.1017/s0022215108003708 ◽

2008 ◽

Vol 123 (4) ◽

pp. 383-390 ◽

Cited By ~ 11

Author(s):

K V Bhat ◽

K Naseeruddin ◽

U S Nagalotimath ◽

P R Kumar ◽

J S Hegde

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Controlled Study ◽

Hearing Improvement ◽

Tertiary Referral Hospital ◽

Suppurative Otitis Media ◽

Disease Eradication ◽

Cortical Mastoidectomy ◽

Randomised Controlled Study ◽

Randomised Controlled

AbstractObjective:This study aimed to compare outcomes for mastoidotympanoplasty and for tympanoplasty alone in cases of quiescent, tubotympanic, chronic, suppurative otitis media.Study design:Single-blinded, randomised, controlled study within a tertiary referral hospital.Methods:Sixty-eight cases were randomly allocated into two groups. In group one, 35 ears underwent type one tympanoplasty along with cortical mastoidectomy. In group two, 33 ears underwent type one tympanoplasty alone. Outcome measures were as follows: perforation closure and graft uptake, hearing improvement, disease eradication, and post-operative complications.Results:There were no statistically significant differences in hearing improvement, tympanic perforation closure, graft uptake or disease eradication, comparing the two groups at three and six months post-operatively.Conclusion:Mastoidotympanoplasty was not found to be superior to tympanoplasty alone over a short term follow-up period. Hence, it may not be necessary to undertake routine mastoid exploration at this stage of disease.

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Comparative study of type I tympanoplasty using temporalis fascia and tragal cartilage with perichondrium as graft material

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181873 ◽

2018 ◽

Vol 4 (3) ◽

pp. 789

Author(s):

Arvinder Singh Sood ◽

Pooja Pal ◽

Anshul Singla

Keyword(s):

Tertiary Care ◽

Chronic Otitis Media ◽

Type I ◽

Graft Material ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Tertiary Care Centre ◽

Fascia Graft ◽

Uptake Rates

Background: Temporalis fascia and cartilage are the most commonly used graft materials, though contradictory reports are available in literature as regards their efficacy. The purpose of this study was to compare graft acceptance and auditory outcomes of tympanoplasty using cartilage versus temporalis fascia as graft material.Methods: This prospective study included 40 consecutive cases of chronic otitis media in a tertiary care centre randomised in two groups of 20 patients each to be subjected to tympanoplasty using either tragal cartilage-perichondrium or temporalis fascia graft from January 2011 to November 2012. Graft uptake rates and subjective as well as objective hearing improvement at 2 months and 6 months postoperative follow-up were compared. Results: The mean age of presentation was 34.4 years (range 15-60 years). At 2 months post operatively, the graft uptake was better with tragal cartilage group (95%) than temporalis fascia (90%), while at the end of 6 months graft uptake was better with temporalis fascia (75%) compared to tragal cartilage (70%). Hearing improvement was better for tragal cartilage group compared to the temporalis fascia group at both 2 months and 6 months follow-up. The subjective improvement in hearing at the end of 6 months was also better for tragal cartilage- perichondrium group than the temporalis fascia group.Conclusions: Both temporalis fascia and tragal cartilage–perichondrium are suitable graft materials for tympanoplasty. Graft uptake was superior with temporalis fascia, while hearing improvement was better with tragal cartilage- perichondrium, although the results were not statistically significant.

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A comparative study of superiorly based circumferential tympanomeatal flap tympanoplasty with anteriorly anchoring flap tympanoplasty in large, subtotal, and anterior tympanic membrane central perforations in chronic suppurative otitis media of mucosal type

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180703 ◽

2018 ◽

Vol 4 (2) ◽

pp. 432

Author(s):

Amitkumar Rathi ◽

Vinod Gite ◽

Sameer Bhargava ◽

Neeraj Shetty

Keyword(s):

Comparative Study ◽

Tympanic Membrane ◽

Otitis Media ◽

Statistical Difference ◽

Chronic Suppurative Otitis Media ◽

Age Group ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Gap Closure ◽

The Mean

Background: The main objective of the study was to assess and compare the graft uptake, hearing improvement, complications in large, subtotal, and anterior moderate perforations by each technique viz; superiorly based circumferential tympanomeatal flap tympanoplasty (STT)/full cuff and anterior anchoring flap tympanoplasty (AAT)/anterior tucking. Methods: In our study of 30 cases age group in the range of 10 years to 60 years. The mean air bone gap for the 8 patients with anterior moderate perforation was 31.75 db, for 17 patients with large central perforations was 38.75 db and for 5 patients with subtotal perforations was 41.4 db. Results: Mean air bone gap closure after 3 months of surgery in the STT group was 21.4 db while that after 6months of the surgery for the same group was 22.06 db. Mean air bone gap closure after 3 months of surgery in the AAT group was 18.2 db while that after 6months of the surgery for the same group was 18.73 db. Conclusions: Comparing the air bone gap closure in patients who underwent surgery by AAT and STT technique we found that there is no statistical difference. Both techniques (viz: superiorly based circumferential tympanomeatal flap tympanoplasty and anteriorly anchoring flap tympanoplasty) can be used for the repair of large, subtotal, and anterior tympanic membrane central perforations in chronic suppurative otitis media of mucosal type.

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Comparative study of outcomes of type-1 tympanoplasty with and without anterior tucking

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201277 ◽

2020 ◽

Vol 6 (4) ◽

pp. 657

Author(s):

Kiran Gangadar S. ◽

G. Priyadarshini

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Tympanic Membrane Perforation ◽

Hearing Improvement ◽

Type 1 Tympanoplasty ◽

Membrane Perforation ◽

Group 2

Background: Tympanoplasty is a surgical procedure for closing the tympanic membrane perforation and reconstructing the tympanic membrane and hearing, commonly after trauma and chronic otitis media. The aim of the study was to compare the clinical and audiological outcomes of tympanoplasty with or without anterior tucking.Methods: In this prospective study, 50 patients with chronic otitis media (COM) were divided into two groups. Group 1 underwent type 1 tympanoplasty with anterior tucking method, and group 2 underwent type 1 tympanoplasty without anterior tucking. The result was measured on graft uptake and hearing outcome at 6 months postoperatively by performing pure tone audiometry. Results: The hearing improvement was almost the same in both the groups. Graft uptake was good in type 1 tympanoplasty with tucking (96%) when compared to without tucking tympanoplasty (92%). Complications like residual perforation were seen in both groups equally. Anterior marginal blunting was noted (8%) in type 1 tympanoplasty with tucking.Conclusions: The hearing improvement of type-1 tympanoplasty with anterior tucking and without anterior tucking is the same. Type-1 tympanoplasty with anterior tucking has a better graft acceptance. The only disadvantage of type-1 tympanoplasty with anterior tucking is anterior marginal blunting.

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