Comparison of results of graft uptake using tragal cartilage perichondrium composite graft versus temporalis fascia in patients undergoing surgery for chronic otitis media - squamous type.

S Khalilullah,D Yadav,H Bhattarai,Shankar P Shah,R P Shrivastav

doi:10.1186/s13005-016-0123-z

Abstract

BackgroundTo assess, analyze and compare the results of graft uptake using Tragal Cartilage-Perichondrium Composite (TCPC) graft with Temporalis Fascia (TF) graft in patients who undergoing surgery for chronic otitis media - squamous type.MethodsPatients aged 13 years and above with diagnosis of chronic otitis media - squamous type undergoing modified radical mastoidectomy, either primary or revision surgery with grafting of tympanic membrane (TM) and patients undergoing excision of postero-superior retraction pocket (PSRP) were included in this study. Patients were divided in two groups: Group A-patients undergoing TCPC graft and Group B -patients undergoing TF graft. Graft uptake results were assessed between 8-12 weeks of surgery.ResultsIn both Groups there were 30 patients each. In Group A successful graft uptake was seen in 27 patients (90 %) and failure of graft uptake was seen in 3 patients(10 %). In Group B successful graft uptake was seen in 28 patients (93.3 %) and failure in 2 patients (6.67 %).Out of the total 60 patients, 11 patients had PSRP. All 6 patients with PSRP in Group A had successful graft uptake and no retraction. Among the 5 patients with PSRP in Group B all patients had sucessful graft uptake, however, in 2 patients retraction of the tympanic membrane was seen similar to the preoperative findings.ConclusionsThere was no statistical difference (p = 0.433) between the use of temporalis fascia or tragal cartilage perichondrium in patients undergoing surgery for chronic otitis media - squamous type.

Highlights

To assess, analyze and compare the results of graft uptake using Tragal Cartilage-Perichondrium Composite (TCPC) graft with Temporalis Fascia (TF) graft in patients who undergoing surgery for chronic otitis media - squamous type
There are different modalities of surgical treatment available, either canal wall up (CWU) or canal wall down (CWD) tympanomastoidectomy depending upon the disease and the patient [3, 4]
It has been found that when Temporalis fascia is Khalilullah et al Head & Face Medicine (2016) 12:26 used as graft material, underlying pathological changes occur in the graft when there is a shallow middle ear cavity resulting in diffuse local retraction, cholesteatoma formation and occasional persistent perforation

Summary

Introduction

Analyze and compare the results of graft uptake using Tragal Cartilage-Perichondrium Composite (TCPC) graft with Temporalis Fascia (TF) graft in patients who undergoing surgery for chronic otitis media - squamous type. Chronic otitis media is still one of the most common ear diseases in many of the developing countries and the prevalence of squamous type of COM is 3.5 % in Nepal [2]. It has been found that when Temporalis fascia is Khalilullah et al Head & Face Medicine (2016) 12:26 used as graft material, underlying pathological changes occur in the graft when there is a shallow middle ear cavity resulting in diffuse local retraction, cholesteatoma formation and occasional persistent perforation. This leads to recurrent infection [5, 6]. Others argue that it may alter the acoustic transfer characteristics of the graft due to the increasing mass and stiffness of the reconstructed tympanic membrane [7]

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