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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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 &lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> Both temporalis fascia and tragal chondroperichondrium are suitable graft materials for tympanoplasty, although graft uptake was clinically better with the use of temporalis fascia.</p><p> </p>

scholarly journals Audiometric evaluation of type 1 tympanoplasty for hearing results

2017 ◽  
Vol 3 (2) ◽  
pp. 332
Author(s):  
Mallikarjun S. Tegnoor ◽  
Kazim Ali ◽  
Sutrave Mithun
Keyword(s):  
Uptake Rate ◽  
Graft Material ◽  
Temporalis Fascia ◽  
Closure Rate ◽  
Hearing Results ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft ◽  
Air Conduction

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">To evaluate the graft uptake rate of the type1 tympanoplasty performed by underlay technique using autologous temporalis fascia graft for the last two years and to assess the hearing improvement in the successfully operated cases with respect to age, sex, size and location of perforation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This prospective Study included 50 patients, who underwent type1tympanoplasty.All operations are performed using an underlay technique and by postural approach. In all the cases, temporalis fascia is used for the reconstruction of TM.<strong> </strong>The data of all the patients regarding preoperative disease, perforation size and location, surgical approach, graft material, pre and postoperative clinical and functional (hearing evaluation by pure-tone audiogram) results are analyzed.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Successful closure rate of the TM perforation is 88% and the graft failure rate is 12%. In this study, lowest and highest age of patients at presentation is 13 and 55 years respectively with a mean age of 26.6 years. Most common approaches is post aural. The mean pre and post-operative air conduction threshold in the successful cases are 33.34 dB and 20.20 dB respectively with a mean audiological improvement of around 13 dB. The improvement in the hearing is achieved in only 88% (44 out of 50) among the successful operated type 1 tympanoplasty. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Type 1 tympanoplasty is a safe and effective technique to improve the quality of life of patients. The most common approach is postural. The graft uptake rate is better at three months. The improvement in hearing is noted irrespective of age, sex, size and location of perforation.</span></p>

scholarly journals Comparison of Reinforcement Cartilage Graft and Temporalis Fascia Graft in Type 1 Tympanoplasty

2021 ◽  
Vol 27 (2) ◽  
pp. 104-110
Author(s):  
Md Mainul Islam ◽  
Kanu Lal Saha ◽  
Harun Ar Rashid Talukder ◽  
Md Khalid Mahmud ◽  
Riashat Azim Majumder ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Uptake Rate ◽  
Cartilage Graft ◽  
Temporalis Fascia ◽  
Hearing Gain ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft ◽  
Cartilage Tympanoplasty

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

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

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

scholarly journals A comparative study of hearing outcome in patients undergoing type 1 tympanoplasty using temporalis fascia versus sliced tragal cartilage

2021 ◽  
Vol 7 (2) ◽  
pp. 258
Author(s):  
Vinod Shinde ◽  
Tejal Sonar ◽  
Shikha Shah ◽  
Ashutosh Kumar ◽  
Anuja Satav
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
P Value ◽  
Temporalis Fascia ◽  
Duration Of Symptoms ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft ◽  
Group A ◽  
The Mean

<p class="abstract"><strong>Background:</strong> A tympanoplasty is a surgical procedure to close a tympanic membrane perforation and reconstruct the tympanic membrane and hearing, commonly after chronic otitis media and trauma.</p><p class="abstract"><strong>Methods:</strong> 50 patients were divided into 2 groups and underwent type-1 tympanoplasty using temporalis fascia versus sliced tragal cartilage. The patient was placed in supine position. Antiseptic painting and draping was done. All cases were operated under local anaesthesia. Post aural approach with post aural Wilde’s incision with 15 number blade, the incision was made 5-10 mm posterior to post aural groove. Temporalis fascia graft was harvested. Tragal cartilage, incision was taken over the under surface of the tragus and tragal cartilage was sliced.  </p><p class="abstract"><strong>Results:</strong> The mean duration of symptoms was 12.72 and 15.84 months in group A and B respectively. Reduced hearing was noted in 21 and 24 patients, ear discharge in 21 each and giddiness in 2 and 4 patients respectively in group A and B. The difference was non-significant when the symptoms were evaluated. Improvement in AB gap was significantly better in group B with a p value of 0.042. The mean improvement was 14.2 dB and 17 dB respectively.</p><p class="abstract"><strong>Conclusions:</strong> Type-1 tympanoplasty using the sliced tragal cartilage may be associated with better improvement in AB gap and can be regularly employed compared to temporalis fascia method.</p>

Comparative study of use of dry and wet temporalis fascia Graft in type-1 Tympanoplasty

2019 ◽  
Vol 02 (02) ◽  
pp. 6-10
Author(s):  
Naveen K ◽  
Jyothi Swarup R ◽  
Mohan M ◽  
Mereen Susan Roy ◽  
Sanjana P
Keyword(s):  
Comparative Study ◽  
Temporalis Fascia ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft

scholarly journals Comparative study of graft materials used in myringoplasty

2019 ◽  
Vol 5 (3) ◽  
pp. 549
Author(s):  
Anchal Gupta ◽  
Apurab Gupta ◽  
Padam Singh Jamwal
Keyword(s):  
Comparative Study ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Central Perforation ◽  
Fascia Graft ◽  
Group 2 ◽  
Group 1

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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 &gt;15 db. In Group 2, 72% had gain of 15 db and 8% had gain of &gt;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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals Unilateral Versus Bilateral Frontalis Suspension Sling Surgery for Correction of Severe Unilateral Congenital Ptosis.

2020 ◽  
Vol 9 (1) ◽  
pp. OT05-OT08
Author(s):  
Jyoti Dhaka ◽  
Ashok Kumar Grover
Keyword(s):  
Comparative Study ◽  
Surgical Outcome ◽  
Fascia Lata ◽  
P Value ◽  
Congenital Ptosis ◽  
Sling Surgery ◽  
Frontalis Suspension ◽  
Cosmetic Outcomes ◽  
Group 2 ◽  
Group 1

Background: To compare the surgical outcome of unilateral silicone sling with bilateral fascia latafrontalis suspension surgery for severe unilateral congenital ptosis.Subjects and Methods:This prospective, interventional and comparative study examined 30 patients of severe unilateral congenital ptosis. 30 patients were divided in to 2 groups, group 1 included 15 patients who underwent unilateral silicone sling frontalis suspension surgery and group 2 included 15 patients who underwent contralateral levator excision with bilateral fascia latafrontalis sling surgery.Results:Mean improvement in MRD1 after surgery in group 1 who underwent unilateral silicone sling surgery was 3.9+1.18 mm and in group 2 who underwent bilateral fascia lata it was 4.9+0.89 mm (p value 0.0001). Excellent results (difference of lid height <1 mm) were seen in 93.3% patients who underwent bilateral fascia latafrontalis sling while in 73.3% patients of unilateral silicone sling. All patients who underwent bilateral fascia lata showed excellent lid crease (symmetric without obliteration) and 80% of the patients who underwent unilateral silicone sling surgery (p value 0.032).Conclusion: Functional and cosmetic outcomes regarding MRD1, symmetry of lid height, lid crease were noted better in group 2 patients who underwent contralateral levator excision with bilateral fascia latafrontalis suspension surgery as compared to group 1 patients who underwent unilateral silicone sling surgery.

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

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

<p class="abstract"><strong>Background:</strong> The objective of the study was to identify the factors which significantly influence type 1 tympanoplasty success.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> None of the factors proved to have a significant influence on tympanic membrane closure or hearing gain.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

P6580Prevalence and clinical significance of latent Brugada syndrome in juvenile lone atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Fathy ◽  
L Gaido ◽  
S Quaranta ◽  
M Anselmino ◽  
C Giustetto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Family History ◽  
Clinical Characteristics ◽  
Young Patients ◽  
P Value ◽  
Lone Atrial Fibrillation ◽  
History Of ◽  
Group 2 ◽  
Group 1

Abstract Introduction Brugada syndrome (BrS) cause about 20% of sudden cardiac death (SCD) in young healthy adults. Nearly 20% of Brugada patients develop supraventricular arrhythmias, mostly atrial fibrillation (AF). But whether lone AF may be the first clinical manifestation in young patients with latent BrS remains unclear. Purpose To estimate the prevalence and clinical significance of latent Brugada ECG pattern in young population (age ≤45 years) with lone AF. Methods A total of 78 patients with lone atrial fibrillation (mean age 35±7) were selected from 111 young patients with juvenile atrial fibrillation (age ≤45 years) between January 2015 and November 2017. All patients were clinically evaluated. Moreover 12 lead-24H Holter ECG and pharmacological class 1C antiarrhythmic drug (AAD) test were done for high suspicious cases of Brugada ECG. The diagnosis of Brugada ECG pattern was established according to the second consensus report criteria 2005 and since 2013, according to HRS/EHRA/APHRS expert consensus statement. Results According to the study protocol, we considered two groups of patients, group 1: 13 patients (16.7%; mean age 37±8) were diagnosed with type 1 Brugada ECG pattern (3 during class 1C AADs therapy and 10 induced by class 1C AAD test), group 2: 65 patients (83%; mean age 35±7) diagnosed as lone AF without type 1 Brugada ECG. The clinical characteristics of the two groups are described in table 1. Regarding to group 1, two patients had positive electrophysiological study with subsequent ICD implantation and genetic test for SCN5A mutation was positive in 3 patients. Table 1. G1, G2 clinical characteristics Patients characteristics Group 1 (n=13) Group 2 (n=65) P value Mean age (years) 37±8 35±7 0.42 Gender (Male %) 7 (54%) 54 (83%) 0.02 Family history of BrS 2 (15%) 0 (0%) 0.03 Family history of SCD 1 (8%) 1 (1.5%) 0.20 Syncope 4 (31%) 5 (8%) 0.02 Sick Sinus Syndrome 1 (8%) 7 (11%) 0.70 Paroxysmal AF 12 (92%) 54 (83%) 0.40 Suspected basal ECG for BrS 13 (100%) 28 (43%) <0.01 Statistical test is considered significant when p value <0.05. Conclusions Up to our knowledge this study is the first one that estimate the prevalence of latent BrS in juvenile lone AF patients. Young patients with lone AF had a high prevalence of latent BrS. Syncope, family history of SCD and family history of BrS are significant indicators of the presence of latent BrS in young patients with lone atrial fibrillation.

Success rate of type 1 tympanoplasty: a comparative study

2021 ◽  
pp. 1-5
Author(s):  
H Odat ◽  
M Alali ◽  
Y Kanaan ◽  
M Al-Qudah
Keyword(s):  
Comparative Study ◽  
Success Rate ◽  
Outcome Measures ◽  
Temporalis Fascia ◽  
Type 1 Tympanoplasty ◽  
Paediatric Patients ◽  
Graft Take ◽  
The Difference

Abstract Objectives This study aimed to compare graft take rate after tympanoplasty between adults and paediatric patients, cartilage and fascia grafts, and overlay and underlay techniques. Methods Data were analysed in groups according to the technique (underlay vs overlay), age (paediatric patients vs adults) and graft (cartilage vs temporalis fascia). The main outcome measures were full graft take and the incidence of complications. Results A total of 198 patients (208 ears) were included. Overall, full graft take was achieved in 200 ears (96 per cent). The success rate was higher in adults compared with paediatric patients (97.5 per cent vs 92.25, respectively) but the difference was insignificant. Similarly, higher but insignificant graft take rate was found in the cartilage group compared with fascia group (98.6 per cent vs 94.9 per cent, respectively). Conclusion All cases of overlay tympanoplasty had full graft take (success rate 100 per cent). In the underlay group, successful graft take was achieved in 154 cases (95 per cent). This difference was statistically insignificant.

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