Outcome of Graft Uptake and Hearing Results between ‘U’ Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation

2018 ◽  
Vol 16 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Sundar Dhungana ◽  
Pabina Rayamajhi ◽  
Rakesh Prakash Shrivastav
Keyword(s):  
Tympanic Membrane ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Results ◽  
Flap Technique ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Subtotal Perforation ◽  
The Mean

Background: Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between ‘U’ flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.Methods: Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sizedanterior and subtotal perforationof tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in ‘U’ flap group and thirty twocases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Results: Graft uptake rate was 90.3%(28/31) in‘U’ flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in ‘U’ flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).Conclusions: The graft uptake rate and hearing results of ‘U’ flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group.

scholarly journals Outcome of Graft Uptake and Hearing Results between ‘U’ Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation

2018 ◽  
Vol 16 (3) ◽  
pp. 297-301
Author(s):  
Sundar Dhungana ◽  
Pabina Rayamajhi ◽  
Rakesh Prakash Shrivastav
Keyword(s):  
Tympanic Membrane ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Results ◽  
Flap Technique ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Subtotal Perforation ◽  
Anterior Perforation

Background: Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between ‘U’ flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.Methods: Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sized anterior and subtotal perforation of tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in ‘U’ flap group and thirty two cases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Results: Graft uptake rate was 90.3%(28/31) in‘U’ flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in ‘U’ flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).Conclusions: The graft uptake rate and hearing results of ‘U’ flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group. Keywords: Anterior perforation; myringoplasty; subtotal perforation; ‘U’ flap.

scholarly journals Comparison of Graft Uptake and Postoperative Hearing Results between Butterfly-Cartilage and Temporalis-Fascia Myringoplasty

2020 ◽  
Vol 42 (1) ◽  
pp. 7-11
Author(s):  
Amiya K Sah ◽  
Pabina Rayamajhi ◽  
Hari Bhattarai
Keyword(s):  
Otitis Media ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Temporalis Fascia ◽  
Hearing Results ◽  
Pars Tensa ◽  
Hearing Status ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

Introduction Myringoplasty is one of the commonest surgeries done in Otology for chronic otitis media- mucosal type (COM-mucosal type). The objective of this study was to compare the graft uptake and post-operative hearing status between butterfly-cartilage and temporalis-fascia myringoplasty. MethodsPatients of age ≥15 years with COM-mucosal type with dry, small to medium sized central perforation of pars tensa with clearly visible perforation margin were randomized into two groups of butterfly-cartilage myringoplasty and temporalis-fascia myringoplasty. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups. ResultsThirty-one patients in butterfly cartilage group and twenty-nine patients in temporalis fascia group were analysed. Graft uptake rate was 93.5% (29/31) in butterfly group and it was 86.2% (25/29) in temporalis fascia group with no statistically significant difference (p= 0.34) between the two groups. The mean pre and post-operative air bone gap in butterfly cartilage group were 20.65dB±8.35 dB; 12.86dB±7.39dB and that in the temporalis fascia group were 19.72±6.14dB, 13.16dB±6.26dB respectively. The difference of preoperative and postoperative hearing status, obtained within the two groups was statistically highly significant (p< 0.001). However, there was no statistically significant difference in hearing results between the two groups (p= 0.54). ConclusionThe graft uptake rate and hearing results of butterfly-cartilage group and temporalis-fascia group were statistically significant within the group after myringoplasty but there was no statistically significant difference in between the two methods.

scholarly journals Endoscopic tympanoplasty using Tutoplast versus conventional microscopic tympanoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Taha M. Abdelaal ◽  
Ahmed A. Ibrahim
Keyword(s):  
Tympanic Membrane ◽  
Operative Time ◽  
Tympanic Membrane Perforation ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Temporalis fascia and perichondrium are still the most successful graft materials for primary microscopic repair of tympanic membrane perforations worldwide with 80% to 90% success rate. However, minimally invasive surgery is becoming standard in many fields and the endoscope has been largely incorporated in ear surgery over the past 10 years. This study aimed to evaluate the success rate of endoscopic transcanal closure of tympanic membrane perforation using Tutoplast® compared with the conventional post auricular approach using homologous temporalis fascia graft. Results Our study was conducted on 50 patients, were equally divided into 2 groups. Group A patients have been operated endoscopic transcanal using the Tutoplast as a graft material. Group B patients have been operated using a temporalis fascia graft through a post-auricular approach. The graft take rate, the pre- and post-operative pure tone audiogram, and operative time were compared in both the groups. The graft uptake rate was 100% in both groups. The mean of ABG showed significant improvement in both groups. In group A, the mean of ABG was 28.2 pre-operatively and became 12.12 post-operatively. In group B, the mean of ABG was 29.72 pre-operatively then became 15.2 post-operatively. Comparing the mean of post-operative ABG between both groups showed statistically significant difference as p value was 0.000496. We found a significant difference of the mean average operative time between both groups as the mean average time for group A was 48.08 min compared to 69.4 min for group B with p value 0.049772295. Conclusions Endoscopic closure of tympanic membrane perforation using Tutoplast is successful short-time procedure avoiding the postauricular or endaural incisions with shorter operative time.

scholarly journals Efficacy of intratympanic injection of Dexamethasone and Triamcinolone on SSNHL

2020 ◽  
Vol 3 (2) ◽  
pp. 52-56
Author(s):  
Mojtaba Meybodian ◽  
◽  
Mohsen Abouii ◽  
Mohammadhossein Dadgarnia ◽  
Mohammadhossein Baradaranfar ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Speech Discrimination ◽  
Hearing Status ◽  
Dexamethasone Group ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Intratympanic Injection ◽  
Medicinal Properties ◽  
Better Than

Objective: The purpose of this study was to compare the effect of intratympanic injection of dexamethasone and triamcinolone on sudden sensorineural hearing loss (SSNHL). Methods: In this study 60 patients with SSNHL were divided into two groups of Dexamethasone 8 mg and Triamcinolone 40 mg. Patients in both groups underwent five injections. Hearing status of the two groups was recorded one day before each injection as well as one week and one month after the last injection at different frequencies. Any possible complications following the injection, such as infection and tympanic membrane perforation was evaluated and recorded. Results: The results showed that after the first and second injection, there was no significant difference between the two groups regarding hearing frequency and speech discrimination score (SDS). Significant differences were observed between the two groups in the third and fourth injections at a frequency of 500 Hz and also in the fifth injection at frequencies of 500, 1000, and 2000 Hz. Tympanic membrane perforation was observed in three patients in the dexamethasone group (P.value>0.05). Conclusion: In our study, the effect of triamcinolone was found to be significantly better than dexamethasone in the treatment of SSHNL at lower frequencies. The SDS was also higher in the triamcinolone group than dexamethasone. Based on our results, intratympanic injection of both triamcinolone and dexamethasone are safe and effective treatments for the treatment of SSNHL, but given its desirable medicinal properties, intratympanic injection of triamcinolone can be a safe and effective alternative for SSNHL treatment.

scholarly journals A Comparative Study between Endoscopic and Microscopic Tympanoplasty

2019 ◽  
Vol 21 (3) ◽  
pp. 195-198
Author(s):  
Anup Dhungana ◽  
R. R. Joshi ◽  
A. S. Rijal ◽  
K. K. Shrestha ◽  
S. Maharjan
Keyword(s):  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Endoscopic Technique ◽  
Random Allocation ◽  
Microscopic Technique ◽  
Significant Difference ◽  
The Mean ◽  
Bone Gain ◽  
Audiometric Test ◽  
Endoscopic Group

A study to compare tympanoplasty between endoscopic and microscopic approach was conducted at NMCTH. Patients diagnosed as chronic otitis media – mucosal type with age of 13 years and above were included in the study. Audiometric test was done before and 6 weeks after surgery. Seventy cases were included for the study with random allocation of cases each in endoscope group and microscopic group respectively. Graft uptake results were assessed after 6 weeks and postoperative hearing were evaluated and compared within and between the two groups. In endoscopic group and microscopic group, the graft uptake rate was 91.4% and 88.5% respectively with no significant difference (p = 0.71) in the graft uptake rate between the groups. The mean pre and post-operative air bone gap in endoscopic group and microscopic group were 34.59 dB±8.02, 21.97±8.60 dB and32.42±10.08 dB, 18.55±8.49 dB respectively. This showed a highly significant difference in both groups(p < 0.001), showing improvement in the hearing after surgery in both the groups. The mean air bone gain were 12.62 dB and 13.87 dB in endoscopic and microscopic group respectively, with no significant difference between the groups (p = 0.553). The graft uptake rate and hearing results with endoscopic technique is comparable to that of microscopic technique. However, the endoscopic technique requires shorter operative time than the microscopic technique. Therefore, we recommend the use of endoscope for tympanoplasty in hospital as well as in camps.

scholarly journals Outcome of Myringoplasty with Temporalis Fascia and Perichondrial-Cartilage Composite Graft in High Risk Perforations

2019 ◽  
Vol 21 (1) ◽  
pp. 60-64
Author(s):  
Anup Dhungana ◽  
RR Joshi ◽  
AS Rijal ◽  
KK Shrestha ◽  
S Maharjan
Keyword(s):  
High Risk ◽  
Tympanic Membrane ◽  
Uptake Rate ◽  
Pure Tone Audiometry ◽  
Composite Graft ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Significant Difference ◽  
The Mean ◽  
And Cartilage

 The objective of this study was to compare the graft uptake results and postoperative hearing of myringoplasty with temporalis fascia and cartilage-perichondrial composite graft in high risk perforations. Patients of age 13 years and above with diagnosis of chronic otitis media – mucosal type with high risk perforation that is >50% perforation of tympanic membrane, revision cases, absent/ eroded handle of malleus, oedematous/unhealthy middle ear mucosa and marginal involvement cases were included for myringoplasty. Pure Tone Audiometry was done within 1 week before surgery. 80 cases were included for myringoplasty which were randomly allocated by lottery method with 40 cases each in temporalis fascia group and cartilage perichondrial composite graft group. Graft uptake results were assessed after 6 weeks and postoperative hearing was evaluated and compared within and between the groups. Graft uptake rate in temporalis fascia group and cartilage perichondrial composite graft group was 90% and 92.5%, respectively with no significance difference in the graft uptake rate (p = 0.692) between the groups. The mean pre and post-operative air bone gap in temporalis fascia group and cartilage perichondrial composite group were 30.69dB±10.19,16.36±8.37dB and 33.73±8.07dB, 20.76±9.47dB, respectively with highly significant difference in both groups (p < 0.001) showing improvement in the hearing after surgery in both groups. The mean air bone gain were 14.33dB and 12.97dB in temporalis fascia and cartilage perichondrial composite group respectively with no significant difference between the groups (p=0.469). The graft uptake rate and hearing results after cartilage perichondrial composite graft are comparable to those of temporalis fascia graft. Furthermore, the cartilage perichondrial composite graft is more rigid and thick so it is more resistant than fascia to anatomic deformation and necrosis. Therefore, we recommend the use of cartilage perichondrial composite graft for tympanic membrane reconstruction in high risk perforation without concern about affecting audiometric results.

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