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

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

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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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MYRINGOPLASTY, TEMPORALIS FASCIA GRAFT PLACED MEDIAL TO THE MALLEUS VERSUS LATERAL TO THE MALLEUS: A COMPARATIVE STUDY

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2016/1366 ◽

2016 ◽

Vol 5 (81) ◽

pp. 6052-6056

Author(s):

Shobhan Babu A ◽

Ranganathswamy D ◽

Shankar T ◽

Vivechana T ◽

Sandeep R

Keyword(s):

Comparative Study ◽

Temporalis Fascia ◽

Fascia Graft

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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

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Comparative study of temporalis fascia graft versus cartilage shield tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182019 ◽

2018 ◽

Vol 4 (4) ◽

pp. 951

Author(s):

Gaurav Chhabra ◽

Amresh K. Saxena ◽

Sanjay Kumar

Keyword(s):

Comparative Study ◽

Uptake Rate ◽

Graft Material ◽

Temporalis Fascia ◽

Fascia Graft ◽

Uptake Rates ◽

Group A ◽

Subtotal Perforation ◽

Group B ◽

The Comparative Study

Background: The objective of the study was to demonstrate the comparative study in terms of graft uptake rate & hearing gain between cartilage shield tympanoplasty and temporalis fascia tympanoplasty in patients with moderate/ large/subtotal perforation.Methods: Cartilage shield tympanoplasty and temporalis fascia tympanoplasty were conducted in Group A and Group B, respectively, each containing 30 patients with moderate/large/subtotal perforations. Pure tone audiogram (PTA) was performed preoperatively and at postoperative visit i.e. at 12th month, a greater than 10-dB closure of air bone gap (ABG) was considered significant. Results: The graft uptake rates were 93.33% and 86.67% in Group A and Group B, respectively, at the end of 10th week. In total, 90% in Group A and 88% in Group B had significant improvement in hearing (ABG ≥10 dB) at 12th week of surgery.Conclusions: Conchal cartilage is a possible graft material for cartilage shield tympanoplasty, especially in moderate, large & subtotal perforation, as it is showed superior autograft as compared to temporalis fascia, not only because of better graft uptake rate and less partial failure but also due to the comparable hearing improvement in terms of mean AB gap in both types of graft materials.

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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.

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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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