Abstract
BackgroundRepair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation.ResultsA total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B.ConclusionUsing temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.
Highlights
Repair of a perforated tympanic membrane can facilitate normal middle ear function, resist infection, and help re-establish normal hearing
Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body
Due to its anatomic proximity, translucency, and suppleness, temporalis fascia is the most preferred grafting materials among the otologists and successful closure is anticipated in approximately 90% of primary myringoplasty [7]
Summary
Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Skin grafts were the first graft materials used in myringoplasty by Horst Wullstein and Fritz Zollner [2, 3] They were discontinued from use because of high failure rates and the formation of cholesteatoma [4]. Connective tissues like fascia lata, dura, temporalis fascia, and vein graft and perichondrium are preferable because they are easier to handle and more resistant to infection, and the problem of cholesteatoma formation is much less [6]. Such an abundance of materials implies that there is no clear-cut favorite and the choice of graft material depends on the individual surgeon’s preference. Due to its anatomic proximity, translucency, and suppleness, temporalis fascia is the most preferred grafting materials among the otologists and successful closure is anticipated in approximately 90% of primary myringoplasty [7]
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