Abstract
Objective/Hypothesis: We have tried to present some of our concerns regarding the usually adopted surgical techniques of Myringoplasty with their possible solutions. Also we have tried to present digital recordings of pre and post-operative findings in reference cases, which have been provided rarely in available literature. Pre- and post-operative pictures and videos of two representative cases are attached. Study design: This prospective study was carried out in MMABM hospital. Forty six (46) ears, 37 patients underwent tympanoplasty by the modified dual grafting technique and the results were analysed. Results: Objectives of tympanic membrane repair, dry ear, closure of AB gap, and stoppage of tinnitus if any, were achieved in all cases. Small residual perforations which healed over time were seen in two cases in cartilage deficient areas. Conclusion: Dual graft modified techniques served as an effective alternative myringoplasty technique.
Highlights
Myringoplasty techniques have already reached a pinnacle with all the described techniques producing excellent results [1] [2] [3]
Objective/Hypothesis: We have tried to present some of our concerns regarding the usually adopted surgical techniques of Myringoplasty with their possible solutions
Forty six (46) ears, 37 patients underwent tympanoplasty by the modified dual grafting technique and the results were analysed
Summary
Myringoplasty techniques have already reached a pinnacle with all the described techniques producing excellent results [1] [2] [3]. Efforts to overcome the concern: 1) Placement of cartilage with or without temporalis facia graft gives a stiffness and strength to the neo-tympanum which may not perforate that in case of any trauma (like barotrauma). Care is taken to place the cartilage pieces below the level of ossicles preferably below the level of neck of malleus This theoretically reduces the chances of block of ventilation channels and reduces the incidence of post-operative retraction pockets. As the placement of graft takes much less time when the cartilage is already in place, the overall operating time is not significantly affected Use of such a technique further strengthens the belief that tympanoplasty/myringoplasty is a high output surgical procedure with a universal success rate and excellent surgical outcome despite any modifications adopted
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