Abstract
Background: The aim of this analytical study is to compare the hearing improvement in type I Tympanoplasty between Temporalis Fascia used alone and temporalis Fascia with cartilage as graft material. Material and Methods: The study was done in ENT department at PSGIMSR, from October 2016 to July 2018. A total of 21,453 cases attended the ENT Outpatient department during the study period. Out of these, 75 cases with dry perforation of the tympanic membrane were chosen for the study. Patients were selected in random, excluding ear discharge, Attico-antral disease, and complications of chronic otitis media. Results: In the study population, disease afflicting the nose and throat were also ruled out. Detailed evaluation of each case was done comprising of history taking, clinical examination, investigations including pure tone audiometry. Patients were divided into 2 groups. Group A consist of 50 patients underwent type I Tympanoplasty with temporalis fascia alone. Group B consist of 25 patients underwent type I Tympanoplasty with combined Temporalis Fascia & Conchal Cartilage. Post-operative hearing improvement measured by Audiometry is compared among the two groups and found that small perforations had best improvement with Temporalis Fascia graft, large and subtotal perforation had good improvement in postoperative hearing with combined Temporalis Fascia and Conchal Cartilage graft. Conclusion: Mean hearing improvement in Group A with temporalis graft was 12.98 dB (better) than Group B, with Temporalis Fascia & Cochal Cartilage graft mean hearing improvement was 8.96 dB.
Highlights
Tympanoplasty is done primarily to achieve a dry ear by eradicating middle ear disease and hearing improvement by closure of any Tympanic Membrane perforation by grafting with/without Ossicular reconstruction
The result of Tympanoplasty is measured by the success or failure of the graft uptake and hearing improvement
In a total of 75 patients, temporalis fascia was used as graft material in 50 patients (66.7%) and Conchal cartilage with fascia was used as graft in 25 patients (33.3%) (Figure 1)
Summary
Tympanoplasty is done primarily to achieve a dry ear by eradicating middle ear disease and hearing improvement by closure of any Tympanic Membrane perforation by grafting with/without Ossicular reconstruction. The greatest advantage of the Cartilage graft is its very low metabolic rate The aim of this analytical study is to compare the hearing improvement in type I Tympanoplasty between Temporalis Fascia used alone and temporalis Fascia with cartilage as graft material. Group A consist of 50 patients underwent type I Tympanoplasty with temporalis fascia alone. Group B consist of 25 patients underwent type I Tympanoplasty with combined Temporalis Fascia & Conchal Cartilage. Post-operative hearing improvement measured by Audiometry is compared among the two groups and found that small perforations had best improvement with Temporalis Fascia graft, large and subtotal perforation had good improvement in postoperative hearing with combined Temporalis Fascia and Conchal Cartilage graft. Conclusion: Mean hearing improvement in Group A with temporalis graft was 12.98 dB (better) than Group B, with Temporalis Fascia & Cochal Cartilage graft mean hearing improvement was 8.96 dB
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