A PROSPECTIVE COMPARATIVE STUDY OF A-B GAP IMPROVEMENT IN PURE TONE AUDIOMETRY BETWEEN CSOM CASES UNDERGOING TYPE 1 TYMPANOPLASTY USING TRAGAL PERICHONDRIUM AND TEMPORALIS FASCIA GRAFT

Aim: To ascertain whether the A-B gap improvement of tragal perichondrial grafting is better than TF grafting in CSOM patients undergoing type 1 tympanoplasty by underlay technique. Methodology: A prospective comparative study was done in CSOM patients presenting to a tertiary health care establishment. 60 patients underwent type 1 tympanoplasty, using TF graft in 30 and tragal perichondrial graft in 30 patients. Both groups of patients were compared in terms of A-B gap improvement following surgery. Results: A-B gap improvement of all the 60 patients were analysed. 8(26.67%) patients had A-B gap improvement </= 15dB in both the tragal perichondrium and TF graft group. Rest 22(73.33%) patients had A-B gap improvement of 16-25dB in either group. In cartilage group, 14 out of 15 patients i.e, 93.33%, while in Fascia group, 10 out of 12 pateints i.e, 83.33% patients who had perforation involving anterior quadrant had A-B gap closure between 16-25dB post- operatively. Therefore, cartilage graft showed better A-B gap closure than fascia graft in anterior quadrant. When both the quadrants were taken into consideration, 11 out 17 i.e, 65% patients in fascia group while 8 out of 13 i.e, 61% patients in cartilage group showed AB gap closure between 16-25dB. Therefore, fascia graft showed better result. Conclusions: This study showed that A-B gap improvement is similar in CSOM patients undergoing type 1 tympanoplasty using either TF or tragal perichondrial graft. Either of these can be good for improving the hearing in CSOM patients but tragal cartilage with perichodrium showed better results with perforation involving anterior quadrants.

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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

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Pre-operative and post-operative audiological evaluation of type 1 tympanoplasty and comparison between temporalis fascia graft and tragal perichondrium graft

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212128 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1031

Author(s):

Satguru Saran Singh ◽

Sandip M. Parmar ◽

Abhey Sood ◽

Nilank Saroha ◽

Meenu Chaudhary

Keyword(s):

Pure Tone Audiometry ◽

Major Effect ◽

Medium Size ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Large Size ◽

Fascia Graft

Background: Aim of the study was to evaluate the hearing improvement of type 1 tympanoplasty performed by using autologous temporalis fascia and autologous tragal perichondrium graft in successfully operated and graft uptake cases, with respect to age, sex, size of perforation and type of graft.Methods: This prospective study consists of total 100 patients with chronic suppurative otitis media (CSOM) tubotympanic disease who have undergone type 1 tympanoplasty. Randomization of patients was done. Every alternate patient was divided accordingly in to two groups-one in temporalis fascia graft group and another in tragal perichondrium graft group. Pure tone audiometry (PTA) was performed preoperatively and 3 months after surgery. Cases with successful graft uptake were included in the study. Statistical comparisons were performed using the t test, and ANOVA test.Results: In this study maximum numbers of patients were found in the age group of 15-30 years. Study showed that audiological benefits were more in males in comparison to females. Large size of perforation showed more improvement due to more air bone gap in comparison to medium size and small size perforation of ears. Audiological improvement occurred in 94% of cases, 3% cases worsened and 3% cases showed no change. More improvement was found in temporalis fascia graft in comparison to tragal perichondrium graft.Conclusions: Type 1 tympanoplasty is a safe and effective technique to improve the quality of life of patients. Size of perforation, type of graft was found to have a major effect on the final outcome of surgery.

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

Research Journal of Medical and Allied Health Sciences ◽

10.46319/rjmahs.2019.v02i02.002 ◽

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

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OUTCOME OF TYPE 1 TYMPANOPLASTY WITH CARTILAGE-PERICHONDRIUM GRAFT IN COMPARISON WITH TEMPORALIS FASCIA

10.36106/ijsr/7933348 ◽

2021 ◽

pp. 1-3

Author(s):

Shambhu Sharan Gupta ◽

Satish Kumar ◽

Debarshi Jana

Keyword(s):

Pure Tone Audiometry ◽

Temporalis Fascia ◽

Type 1 Tympanoplasty ◽

Fascia Graft ◽

Middle Ear Pressure ◽

Group A ◽

Group B ◽

Sound Conduction ◽

Rate Of Failure

Objective: To compared the outcome of Type 1 tympanoplasty with cartilage-perichondrium graft in comparison with temporalis fascia graft in terms of post-operative graft take-up and hearing results. Materials and Methods: A prospective observational study among 80 patients between 15 and 60 years of age satisfying the inclusion criteria with complaints of ear discharge and hearing loss due to COM - mucosal type was conducted. Patients were grouped in two groups of 40 patients each. Group A patients underwent Type 1 tympanoplasty with temporalis fascia and Group B with cartilage-perichondrium graft. Patients were followed up for graft uptake, hearing improvement and rate of failure are compared for both the grafts. Graft uptake was assessed at the end of the 1st month, 3rd month, and 6th month, and hearing was assessed at the end of the 6th month with pure tone audiometry. Results: Patients with temporalis fascia graft showed a take-up rate of 80% and cartilage-perichondrium graft of 92.5% by 6 months. Among the fascia group, graft failure was seen in 20% (8). One patient had failed take-up of graft and four patients showed reperforation. In cartilage group, three patients showed failure of take-up of graft during the 1st month. No patient had reperforation or retraction. Air-bone gap in fascia group showed a closure to 10 dB in 17.5% (7). In the cartilage group, 10 dB in 25% (10 patients). In our short-term follow-up of 6 months, we found that cartilage-perichondrial graft reduces the chance of reperforation and retraction even with variation in middle ear pressure due to eustachian tube catarrh. It gives good take-up rate and comparable hearing result as that of the fascia graft. It does not affect the sound conduction when thinned out to appropriate thickness. It is available from the same surgical field and in sufficient quantity for the closure of the TM defect. Cartilage-perichondrium graft for Type 1 tympanoplasty could be a successful replacement for temporalis fascia giving good result with neotympanum.

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Comparative study between result of temporalis muscle fascia and tragal cartilage perichondrium as a graft material in type 1 tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180726 ◽

2018 ◽

Vol 4 (2) ◽

pp. 565

Author(s):

Abhay Kumar ◽

Prabhu Narayan ◽

Prem Narain ◽

Jaypal Singh ◽

Prateek Kumar Porwal ◽

...

Keyword(s):

Otitis Media ◽

Pure Tone Audiometry ◽

Chronic Suppurative Otitis Media ◽

Graft Material ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Hearing Results ◽

Group Type ◽

Type 1 Tympanoplasty

Background: Leading cause of deafness in India is chronic suppurative otitis media. Most common cause of TM perforation is chronic suppurative otitis media. With this background this study was to compare hearing results, as well as graft takes for commonly preferred reconstruction techniques of the TM (i.e., temporalis fascia vs. cartilage) in tympanoplasty.Methods: The present study consists of 60 cases of C.S.O.M (TTD) which was divided into two groups with 30 cases in each group. In first group type1 tympanoplasty was done by Temporalis fascia technique. In second group type 1 tympanoplasty done by tragal cartilage with perichondrium technique. History and otoscopic examination along with pure tone audiometry was performed preoperatively. Postoperative hearing results and graft uptake were compared between two groups, all surgeries were performed through the post aural approach. Results: Graft uptake results are better with tragal cartilage with perichondrium technique. Hearing improved significantly in both groups. Though this was slightly better in TFT, but not significant statistically.Conclusions: Graft uptake rates are better with the tragal cartilage with perichondrium technique in comparison of TFT and hearing results are almost equivalent with both techniques.

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853 A PROSPECTIVE COMPARATIVE STUDY OF TERLIPRESSIN AND ALBUMIN FOR TYPE-1 HEPATORENAL SYNDROME (HRS) IN PATIENTS WITH CIRRHOSIS AND SPONTANEOUS BACTERIAL PERITONITIS (SBP) VS CIRRHOSIS ALONE

Journal of Hepatology ◽

10.1016/s0168-8278(10)60854-9 ◽

2010 ◽

Vol 52 ◽

pp. S332 ◽

Cited By ~ 1

Author(s):

M. Rivero ◽

M. Rodríguez-Gandía ◽

R. Serradilla ◽

G. Arranz ◽

J.M. Milicua ◽

...

Keyword(s):

Comparative Study ◽

Spontaneous Bacterial Peritonitis ◽

Hepatorenal Syndrome ◽

Bacterial Peritonitis ◽

Prospective Comparative Study ◽

Type 1 Hepatorenal Syndrome

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Audiometric evaluation of type 1 tympanoplasty for hearing results

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171188 ◽

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

Background: 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. Methods: 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. 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. Results: 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. Conclusions: 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.

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Clinical study on type 1 tympanoplasty: anatomical and functional outcomes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193675 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1197

Author(s):

A. Kusumanjali ◽

V. Krishna Chaitanya

Keyword(s):

Success Rate ◽

Middle Ear ◽

Pure Tone Audiometry ◽

Type I ◽

Middle Ear Mucosa ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Cortical Mastoidectomy ◽

Type I Tympanoplasty

Background: Tympanoplasty is operation to eradicate disease in middle ear and to reconstruct the hearing mechanism. Present study aims at assessment of success rate and hearing improvement following type I tympanoplasty.Methods: 50 patients with chronic suppurative otitis media, tubotympanic type attending department of ENT are taken up for study screened with clinical history and examination. Type I tympanoplasty performed in all patients. Simple mastoidectomy with type I tympanoplasty performed in 8 patients. Patients are followed after surgery on 7th, 14th days and end of 3 months. Anatomical outcome is assessed in terms of graft uptake. Pure tone audiometry was performed at 3 months and air bone gap is considered to assess outcome. Results: Out of 50 cases, 43 cases (86%) showed good success rate by means of graft uptake. Remaining 5 cases showed residual perforation and 3 cases medialization of graft. In 42 patients type1 tympanoplasty is performed, success rate was 80.95% and in cases with where type1 tympanoplasty with cortical Mastoidectomy was done and the success rate was 100%. In the present study mean pre op AB gap was 27.65 dB and mean post op AB gap was 19.07 dB. The difference between the two, i.e., AB gap closure was 8.52 dB which is statistically significant.Conclusions: Type-1 tympanoplasty using temporalis fascia with underlay technique have good surgical success rate with excellent improvement of hearing. Cortical mastoidectomy can be planned depending on the status of the middle ear mucosa.

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