Surgical Outcomes of Tympanoplasty with Various Graft Materials in Chronic Otitis Media: A Retrospective Cohort Study

Abstract

Introduction: Chronic Otitis Media (COM) is a common ear disorder that predominantly affects underdeveloped countries. It is characterised by persistent middle ear discharge and a perforated Tympanic Membrane (TM). Management typically involves antibiotics and surgical techniques like tympanoplasty to eradicate infections and improve the auditory conduction system. Various graft materials are used, with temporalis fascia being preferred due to its proximity and ease of harvesting. Aim: To evaluate the surgical outcomes of tympanoplasty procedures utilising different graft materials in patients diagnosed with inactive mucosal COM. Materials and Methods: This retrospective cohort study was conducted in the Department of Otorhinolaryngology at Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, Maharashtra, India, between June 1, 2013, and May 31, 2023. A total of 165 participants with inactive mucosal COM, who had small to subtotal central perforations of the TM, were included. Tympanoplasty, performed by the same surgeon using the Zeiss surgical microscope model OPMI under general anaesthesia, was the chosen surgical procedure. All cases were executed using the postauricular approach with the underlay technique. A successful anatomical outcome was defined as an intact neoTM without residual perforation at the end of a three-month follow-up. Results: The age of participants ranged from 10 to 75 years, with a mean age of 32.45±14.06 years. The age group most frequently affected by mucosal COM was between 31-40 years, comprising 41 (24.85%) cases. Large perforations were observed in 79 (47.88%) patients, followed by moderate perforations in 65 (39.39%) patients. Normal ossicular chains were found in 163 (98.78%) patients, while ossicular erosion was noted in 2 (1.22%) patients during surgery. A total of 118 (100%) patients who came for follow-up, 84 (71.19%) who underwent temporalis fascia graft reconstruction showed successful graft uptake. Conclusion: This study found that both fascia and cartilage tympanoplasty are suitable for TM repair due to their availability.