Graft Uptake Research Articles

An Observational Study to Assess the Outcome of Canal Wall Window Tympanomastoidectomy in Chronic Suppurative Otitis Media.

This study was undertaken to assess the outcome of canal wall window tympanomastoidectomy in chronic suppurative otitis media in a tertiary care centre of central India. A total of 50 patients were taken for this study in which the youngest patient was 13-year-old male and oldest 55-year female. Maximum patients were in between age group 10 to 20 years, 20 (40%) patients and minimum 03 (6%) between age group 51 to 60 year. The study mainly emphasized on: To study the clinical profile of the cases of chronic suppurative otitis media, to study the hearing outcome after 3 months of Canal wall window tympanomastoidectomy technique, to study the post-operative condition of ear after 3 months whether dry or wet and to study the post-operative follow up of cases to assess the graft uptake. Average PTA & ABG improvement of different tympanoplasty was also calculated in our study in which Type I tympanoplasty had 12.20dB gain, Type II of 10.50 and Type III of 10.31dB.An overall average improvement in all patients with tympanoplasty was 11.00dB.At the end of the study 100% dry ears were achieved. The technique of canal wall window tympanomastoidectomy involves formation of a window in the outer attic wall to look at the disease extent which was then closed by a snuggly fitting cartilage.It is a novel technique & without compromising the structural integrity in case of a limited disease which is only extending till attic and aditus good anatomical and hearing results could be gained.

Outcome of Myringoplasty with Temporal Fascia and With Sliced Tragal Cartilage Graft-A Comparative Study

Introduction: Myringoplasty is the surgical procedure to repair tympanic membrane perforations and thereby improving hearing, providing a dry ear, and reducing susceptibility to infections. Although there are many kinds of techniques and graft materials used, no methods have proven indisputably superior to the other. Therefore, to find out the outcome of myringoplasty using temporal fascia and sliced tragal cartilage in chronic inactive mucosal otitis media was set as an objective of the study. Materials and Methods: This cross-sectional observational study was conducted at the department of Otolaryngology & Head-Neck surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH) for six months from July 2018 to December 2018, after acceptance of the protocol and approval from IRB. Patients attending in the ShSMCH with complaints of chronic inactive mucosal otitis media were approached for inclusion of the study and final selection were done in according to the selection criteria. Ethical issues were ensured properly throughout the study period and inclusion was confirmed following signing written informed consent. All patients were randomly allocated into two groups where one group were received myringoplasty with temporalis fascia graft and another group received sliced tragal cartilage. Total 50 patients (25 patients in each group) were included, and they were subjected to details history taking, physical examination and necessary investigations. The researcher conducted all the interview and collected data were recorded into a case record form for each patient. Data analysis was done by SPSS 17. Results: Of total, 50 study population, mean age of the 32.30±10.93 SD (years) with 58% male and 42% females respectively. No significant age and gender difference is noted across the group (p>0.05). Patients having temporal fascia graft had significantly higher proportion of graft uptake in comparison to patients having sliced tragal graft (p<0.05). Both groups of the patient improve significantly in term of hearing after operation (p<0.05 in each group) but comparison in between groups showed that the improvement was significantly higher in temporal fascia graft group (p<0.001). Conclusion: Myringoplasty with temporal fascia graft could be a better option than sliced tragal cartilage graft in our population. However, further larger study with longer follow up is necessary to finalize the comment. Medicine Today 2023 Vol.36 (1): 50-54

Endoscopic transcanal underlay myringoplasty using a platelet-rich fibrin (PRF) membrane

BackgroundTympanic membrane perforations are among the most common indications for otological surgery. Surgeons from all around the world have made accidental and intentional contributions to find the perfect graft material and the best approach to perform tympanoplasty. Platelet-rich fibrin (PRF) use in myringoplasty has been popular in the last decade among many surgeons. We aimed to evaluate the efficacy of using PRF only as a graft material in myringoplasty.MethodsWe conducted a prospective study including 20 patients with dry central tympanic membrane perforations. The patients underwent endoscopic transcanal myringoplasty using a platelet-rich fibrin membrane by underlay technique. Follow-up was done 3 months postoperatively regarding graft uptake and hearing outcome by audiological assessment using pure tone audiometry.ResultsSixty percent of patients were surgically successful with complete healing of the tympanic membrane, 10% were partially successful with partial healing of the tympanic membrane, and 30% failed with complete loss of graft. The mean air-bone gap closure was 3.5 dB. No major complications were reported.ConclusionEndoscopic myringoplasty using platelet-rich fibrin alone can be performed in cases with tympanic membrane perforations as an alternative to using other autologous grafts. It is a new reliable method for myringoplasty, as well as being an easy, time-saving procedure that avoids the need for any skin incision.

Role of diverting colostomy and reconstruction in managing Fournier's gangrene-a narrative review.

To examine the role of bowel diversion and reconstructive surgeries in managing Fournier's gangrene (FG) to facilitate multidisciplinary collaboration between urologists, colorectal and plastic surgery teams. A review of the literature was conducted using the databases Medline, Embase, PubMed in June 2023. The review included studies that evaluated the outcomes of FG following reconstructive surgeries or diverting colostomies. The existing evidence suggests that bowel diversion and colostomy formation could reduce the need for further debridement, shorten the time to wound healing, and facilitate skin graft or flap uptake in patients with FG. Additionally, the psychological impact of a stoma was shown not to be a major concern for patients. However, stoma carries a risk of perioperative complications and therefore may prolong the length of hospital stay. In reviewing the evidence for reconstruction in FG, large and deep defects seem to benefit from skin grafts or flaps. Noticeably, burial of testicles in thigh pockets has grown out of favour due to concerns regarding the thermoregulation of the testicles and the psychological impact on patients. The use of bowel diversion and reconstructive surgeries in managing FG is case dependent. Therefore, it is important to have close discussions with colorectal and plastic surgery teams when managing FG.

A Prospective Comparative Study of Temporalis Fascia Graft versus Platelet-rich Plasma with Temporalis Fascia Graft in the Repair of Tympanic Membrane Perforations

Aim: This study aimed to determine the efficacy and safety of platelet-rich plasma (PRP) as an adjuvant for tympanoplasty for perforations of the tympanic membrane with temporalis fascia versus tympanoplasty with temporalis fascia only. Materials and Methods: A total of 100 patients diagnosed with chronic suppurative otitis media tubotympanic type were divided into groups of 50 each. Patients in group one underwent tympanoplasty with PRP, while those in the second group underwent tympanoplasty without PRP. Pre- and postoperative graft status and pure-tone audiometry were performed for all the patients, and the outcomes were compared. Results: Graft uptake in the case group was 90% and while in the control group was 84%. The result was better in cases that underwent tympanoplasty with PRP. The improvement in the A-B gap was significantly more in the case group as compared to that of the control group. Conclusion: Temporalis fascia graft alone and along with PRP, both techniques has excellent results. The use of PRP along with temporalis fascia in cases of large central perforation gives an additional benefit in respect to healing time and audiological gain.

Exclusive endoscopic management of incus long process major defects: conventional incus interposition versus malleostapediopexy.

The aim of the current study is to compare the surgical and audiometric results of conventional incus interposition (IP) versus malleostapediopexy (MS) in incus long process large defects. A total of 71 patients (incus IP group n = 37, MS group n = 34) were enrolled in this study. All patients enrolled in the current study underwent ossiculoplasty via an exclusive endoscopic transcanal approach. Pre- and postoperative audiometric measurements and air-bone gap (ABG) values were compared, and if the postoperative ABG value was less than 20dB, ossiculoplasty was considered successful. Graft success rates and complications were also compared. The average auditory gain was 14.7 ± 4.2dB in the incus IP group and 18.3 ± 5.1dB in the MS group. The auditory gain was significantly greater in the MS group relative to the incus IP group (p = 0.012). Ossiculoplasty success (postoperative ABG value < 20dB) rate was 70.3% in the incus IP group patients and 88.2% in the MS group patients (p < 0.001). There was no significant difference in terms of graft success rate between groups (p > 0.05) and the overall graft uptake rate was 91.5% (65/71). Malleostapediopexy-bridging of malleus and stapes using bone cement-is an effective, reasonable, and more efficient technique in terms of auditory outcomes relative to the conventional incus interposition in endoscopic transcanal management of incus long process major defects.

The Role of the Middle Ear Risk Index in the Outcome of Tympanoplasty in Terms of Graft Uptake and Hearing Improvement

The Role of the Middle Ear Risk Index in the Outcome of Tympanoplasty in Terms of Graft Uptake and Hearing Improvement

Co2 LASER Therapy as an Option for Non-Healing Surgical Wounds after Radiation Therapy-A Retrospective Study.

Radiation has a huge impact on wound healing with progressive and irreversible impairment at the cellular level, making it very challenging for surgeons in terms of wound healing aftersalvagesurgeryin previously radiated patients. CO2 LASER helps in wound healing by its combined effect yielding a better result. Our study aims to retrospectively evaluate the healing outcome in a series of patients post-radiation, diagnosed with head and neck neoplasm recurrence, undergoing CO2 LASER treatment for non-healing surgicalwounds, post salvage surgeryhaving a previous history of radiotherapy in Head and Neck cancers. A total of seven patients from January 2018 to June 2021 who underwent CO2 LASER treatment in non-healing surgicalwounds, post salvage surgeryhaving a previous history of radiotherapy in Head and Neck cancerswere included in this study. Clinical assessment of healing in terms of complete healing, the appearance of the scar, and patient satisfaction, with a follow-up for 18months. This series included a total of seven patients, five men and two women, aged between 27 and 62years with a mean age of 47years. Three patients had a previous history of radiation, and four patients had a previous history of chemoradiation (CT + RT). Successful healing was noted in all the seven patients. Post-healing all patient's scars were soft, flat, and clinically acceptable. One patient presented with hypopigmentation. CO2 LASER therapy speeds up the healing process with minimal discomfort to the patient. CO2 LASER therapy can be used as an alternative for non-healingsurgical woundsafter salvage surgery in previously radiated patients with an unhealthy wound bed where split-thickness skin graft uptake is unpredictable.

Comparison of Endoscopic Versus Microscopic Tympanoplasty: A Prospective Randomised Study.

To compare endoscopic versus microscopic method for tympanoplasty in terms of Graft uptake and hearing outcome. A randomized prospective observational study was done. 60 patients who came to ENT outpatient of tertiary care teaching hospital requiring operative intervention for inactive mucosal chronic otitis media. Randomization was done and patients divided into two groups with Group A undergoing endoscopic tympanoplasty and Group B undergoing microscopic tympanoplasty. Post operative graft uptake and hearing improvement were compared between both groups. Intraoperatively visualization of middle ear structures, surgeon's comfort, duration of surgery, post operative pain, giddiness was compared. in both the groups. Total 60 patients got randomly divided in the two groups. There was no difference in terms post op graft success rate and post operative hearing improvement in both the groups Intra operative visualization of middle ear structures better in the endoscopic group and also the surgical time was significantly less in endoscopic group. On comparing endoscopic versus microscopic tympanoplasty in patients of mucosal chronic otitis media, success rate in terms of graft acceptance and hearing improvement was equal between both groups. However, visualisation of middle ear structures was better in endoscopic method. Operating time was shorter in endoscopic tympanoplasty. The online version contains supplementary material available at 10.1007/s12070-024-04585-z.

Staged surgical management and its impact on quality of life for stage 3 hidradenitis suppurativa in adolescents

BackgroundHidradenitis suppurativa (HS) can present significant physical, psychological, social, and financial burden. Here, we describe surgical and quality of life outcomes for adolescent patients with axillary Hurley stage 3 HS who underwent staged surgical management. MethodsWe performed a single-center, retrospective review of patients ≤21 years who had axillary Hurley stage 3 HS. A standardized, staged surgical approach was implemented. Primary outcomes were length of stay, length of negative pressure wound therapy (NPWT) use, number of operations, range of motion, and graft uptake. Secondary outcome was depression, suicidal ideation, and social changes including return to school or work. ResultsNine adolescent female patients with axillary Hurley stage 3 HS were included, of whom 6 underwent surgery (9 total sites) and 3 remained on medical therapy. Patients had 6.5 ± 4.6 visits to the emergency department prior to surgery referral and had undergone 7.5 ± 5.1 incision and drainage procedures. For patients undergoing surgical management, NPWT duration was 23 ± 4 days, with 2–3 NPWT changes. Graft uptake was 80–100 % with 100 % return of full range of motion. No disease recurrence has been noted. All patients undergoing surgical management reported improvement in depression and suicidal ideation. ConclusionWell-defined staged surgical approach for axillary Hurley stage 3 HS can offer adolescent patients disease eradication, improvement in range of motion, and improvement in quality of life. Study typeRetrospective review, case series. Level of evidenceIV.

Comparison between endoscopic and microscopic type 1 tympanoplasty using temporalis fascia graft

Aim: is to compare the outcomes of endoscopic vs microscopic type 1 tympanoplasty in patients with central perforation in tympanic membrane with conductive hearing loss. Materials and methods: This study was conducted in the Department of Otorhinolaryngology, at a tertiary care hospital and medical college, Odisha. This study was a hospital based single centered simple randomised control trial. A total of 100 cases of CSOM randomised into endoscopic and microscopic assisted tympanoplasty group (50 each) after taking proper informed consent. The duration of study was from September 2019 - August2021. Results: Out of 100 surgeries, there was one failure of uptake of graft and the patient belonged to the endoscopic group. Operative time was significantly shorter in the endoscopic group as compared to the microscopic group. There was no significant difference in terms of graft uptake and hearing improvement among the two groups. Conclusion: In both microscopic and endoscopic Tympanoplasty have their own advantages and disadvantages, Endoscopic Tympanoplasty offers slight benefits over Microscopic Tympanoplasty in terms of shorter duration, less granulation, less post op pain, wide angled view but it has inherent disadvantages being a single handed procedure. Unlike microscope, endoscope is easily transportable, hence it can be ideally used in camps conducted in remote places&#x0D;

Artificial dermis combined with negative pressure wound therapy and platelet-rich plasma to treat traumatic wounds: a retrospective study.

The reconstruction of complex soft tissue defects with exposure of bones and tendons represents an increasing challenge in wound care, especially in large extremity wounds. The aim of this study was to detect the clinical efficacy of combined use of negative pressure wound therapy (NPWT), artificial dermis (ADM), platelet-rich plasma (PRP) and split-thickness skin grafting (STSG) in the reconstruction of large traumatic extremity skin defects. In this study, eight cases were treated with combined therapies for repairing complex extremity wounds and the results were reviewed retrospectively. After surgical debridement, all wounds received ADM, PRP and delayed STSG, which were all aided with NPWT. The patients consisted of five males and three females, with a mean age of 44 years. A total of six lower extremity wounds were located at the foot/ankle, with exposed tendon in five, bone exposure in three and both in two. Of the group, two patients had exposed tendon on arm/hand wounds. The size of wounds and ADM averaged 126cm2 and 42.3cm2, respectively. ADM was used to cover the exposed bone or tendon, the granulation and muscular tissue were covered with vacuum sealing drainage (VSD) directly, for NPWT. The survival rate of ADM averaged 98.9%. The average time for survival of ADM was 12.8 days and the mean uptake of autologous skin graft was 93.5%. Only one patient received repeated skin grafts. All patients achieved successful healing and reported no complications. The mean length of hospital stay was 36.1 days. Our study revealed that ADM in conjunction with NPWT, PRP and STSG could be used for repairing large traumatic extremity wounds. Wound closure was achieved without flaps, the aesthetic and functional outcomes were acceptable, and only one patient developed a 35% loss of skin graft. This work was supported by grants from the Natural Science Foundation of Hubei Province (grant no. 2020CFB464) and Youth Foundation of Wuhan Municipal Health Commission (grant no. WX20Q15). The authors have no conflicts of interest to declare.

Myringoplasty - A Rewiev of 438 Cases.

The medical records of 438 patients who underwent myringoplasty followed up for a minimum of one year in the period of 1980 and 2015 were revised. Examination under otomicroscope was done of the ear to be operated. This was carried out with a speculum under the operating microscope to be reliably asses the tympanic membrane, site of perforation, to rule out any other pathology and assess the status of ossicular chain. All the patients submitted primary myringoplasty surgery were operated under postauricular, endaural and transcanal approach with overlay, underlay and inlay methods. In the study the patients were divided into three groups depending upon the technique utilized to repair the tympanic membrane. When we compared overlay technique group with underlay technique group, it was observed that overlay technique was no statistically significant difference between these three groups in term of age wise distribution, gender wise distribution, duration of disease and cause of disease, due to matching at the time of selection. In this study the outcome in terms of graft uptake rate was slight better in the overlay technique (94%) as compared to the underlay technique (86.2%), though the difference was statistically insignificant, P>0.05. Patients selection may have had a role in the high success rate in the present study as patients presenting with middle ear pathology were excluded. The complications rate in the present study was quite low, no case in inlay group, three cases of graft lateralization in underlay group, and 19 cases in overlay group. In this study, better results were achieved with overlay technique may probably be due to less surgical manipulation and faster healing process.

Role of Topical Estrogen in Outcomes of Myringoplasty: Does it Really Affect the Results of Graft Success and Hearing Thresholds?

The tympanic membrane forms a barrier between the external auditory canal and the middle ear. In the inactive mucosal type of chronic otitis media, there is a perforation in the tympanic membrane which is surgically managed by Myringoplasty. Estrogen as a growth factor has been shown to have a mitogenic effect on keratinocytes thus hastening the rate of epithelialization following injury. This property of estrogen is being studied in this study for its role in the outcomes of myringoplasty. This study was carried out from January 2021 to December 2022 in the Department of Otorhinolaryngology, of a tertiary teaching hospital in North India. Patients were assessed by history, examination, otoscopy, Audiometry, and oto-endoscopy. A total of 88 patients were taken out of which 44 patients underwent myringoplasty in which topical estrogen (estradiol valerate solution) was used, and the remaining 44 patients were taken as controls. Patients were then assessed post-operatively based on Audiometry results and graft uptake status. In the estrogen group successful Graft uptake was in seen 40 (90.9%) patients and failed in 4 (9.1%), while in the control group, it was successful in 37 (84.1%) patients and failed in 7 (15.9%), statistically there was no significant difference between two groups in terms of graft uptake (p value = 0.334). Post-operatively, in the estrogen group, the mean change in Air Conduction (AC) was 15.5dB, the change in the air-bone gap (ABG) was 11.5dB and for Bone Conduction (BC) it was 3.2dB. However, in the control group mean post-operative changes in Air Conduction, Air-Bone Gap, and Bone Conduction were 12dB, 10.7dB, and 0.8dBrespectively. Statistically, there was a significant difference in postoperative changes in AC (p value = 0.011) and BC (p value = 0.009) between the two groups. There was no significant difference in post-operative changes in Air-Bone Gap (p value = 0.571). Topical Estrogen (Estradiol valerate) solution is cost-effective, with enriched growth factors that accelerate tympanic membrane perforation closure following myringoplasty and resulted in significant improvement in hearing thresholds both for Air Conduction and Bone Conduction.

Hearing Improvement in Tympanoplasty, with and Without Canalplasty.

Primary objective of this study was to compare the role of canalplasty in tympanoplasty, with that of only tympanoplasty, in patients of chronic suppurative otitis media with narrow external auditory canal and moderate to large central perforation, in terms of hearing improvement, graft uptake, intra operative ease. This study included 60 patients with chronic mucosal otitis media with narrow external auditory canal, with moderate to large central perforation, presenting to our institution from September 2019 to August 2021. Group A consisted of 30 patients, who underwent tympanoplasty with canalplasty and Group B consisted of 30 patients, who underwent tympanoplasty without canalplasty. Both the groups were followed up for 3months, compared and analysed for hearing improvement and graft uptake. The results of our study indicated that Group A achieved 93.3% graft uptake rates compared to group B which achieved 80%. In Group A gain in air bone gap was 12.43dB, whereas in Group B it was about 9.50dB. Group A had significant hearing improvement and better graft uptake compared to Group B. It is advantageous to perform canalplasty prior to tympanoplasty in patients with narrow external auditory canal in whom the entire rim of annulus is not visible in one microscopic view. It yields better hearing improvement and graft uptake and prevents lateralization of the graft.

To Study the Outcome of Cartilage Tympanoplasty Type I in Patients with Medium and Large Perforations Using 0.5mm Sliced Conchal Cartilage Reinforced with Temporalis Fascia Grafts with 5 Years Follow-up.

To study the outcome of cartilage tympanoplasty type I in patients with medium and large perforations using 0.5mm sliced conchal cartilage reinforced with temporalis fascia grafts with 5 years follow-up. Retrospective clinical study. 120 patients with dry tympanic membrane perforation medium and large size and intact ossicular chain, and with no history of previous ear surgery were selected. An underlay type one tympanoplasty, using 0.5mm sliced conchal cartilage reinforced with temporalis fascia, was performed during 2018-19. A successful anatomical outcome was considered to comprise full, intact healing of the graft without perforation these patients were evaluated for at least 5 years post-operatively till 2023. In this study graft uptake rate was 95.33% for medium size and 93.66% for large perforations at 3 months and after 5 years of follow-up 92.77% medium size and large size perforations were 89.67.66% (P < 0.001). Residual perforations were there in about 7.29% in medium and 10.33% in large size perfrations. Sliced conchal cartilage reinforced with temporalis fascia is a reliable technique for tympanoplasty, with improved graft uptake results in medium and large perforations in the long-term, also the residual perforations is significantly lower.

A Comparison of Efficacy of Autologous Platelet-rich Plasma and Conventional Sutures in Anchoring Split Skin Graft on Wounds

Abstract Context: Split thickness skin grafting (STSG) restores cutaneous cover over wounds thus protecting the underlying surface from contamination, fluid loss and stimulates healing. Autologous platelet rich plasma (PRP) provides a large number of platelets and high concentration of growth factors which promote overall uptake of STSG. Aims: The aim of this study was to assess the immediate, subsequent adhesion and final take of STSG with application of PRP over recipient site. Methods and Material: 1 year Randomised Control Trial where 80 wounds of various aetiologies were randomised into intervention group (n=40) which received PRP before placing STSG on recipient site and control group (n=40) in which the graft was fixed in place with sutures alone. Immediate graft adhesion and subsequent graft uptake were compared between the two groups and statistical analysis was done with: SPSS Version 20. Results: Irrespective of aetiology, and size, among a total of 80 wounds 87.5% grafts had adhered by 1st minute of application in the intervention group compared to nil in control group (p&lt; 0.0001). Graft uptake was assessed on first three consecutive dressings. There was significantly better graft uptake in intervention group compared to control group [third dressing uptake (98.29%, 93%, p&lt; 0.0001) respectively].Difference in seroma and haematoma formation were also compared between the two groups and found to be not significant. (p&gt;0.05) Conclusions: Application of topical PRP facilitates STSG uptake. It decreases operative time by decreasing mobility of graft over the wound bed. Thus, use of PRP improves outcome of split thickness skin graft in wounds of various aetiologies and we recommend use of the same at recipient site of STSG. CTRI/2021/06/034401

Assessment of Eustachian Tube Function for Successful Tympanoplasty in Chronic Otitis Media

Introduction: Eustachian tube function (ETF) has been the focus of attention as a prognostic factor for successful tympanoplasty surgery, due to its supposed primary pathogenic role in otitis media. Poor Eustachian tube (ET) function has been blamed to many diseases of middle ear cleft extending from serous otitis media to the squamosal type of chronic otitis media (COM). The objective of this study was to evaluate the effect of ETF on tympanoplasty outcome in the mucosal type of COM patients. Materials and Methods: An observational study was conducted for the patients admitted to the department of ENT and HNS with COM, mucosal type. The study was done from April 2021 to March 2022. ETF was assessed with the Toynbee test and saccharin time test. Results: The mean saccharin clearance time was found to be 17 min. Tympanoplasty was performed on 55 patients; 91.1% of patients showed successful outcome with good graft uptake who had normal ETF; out of 20 patients with partial dysfunction, 12 patients had successful graft uptake, and eight patients showed graft rejection. Conclusion: The automatic Toynbee test can be a practical, objective, and suitable method to assess the ventilatory function of ET. The saccharin test is an easy, cost-effective, and useful diagnostic tool to assess the mucociliary function of the ET. The ventilatory function of ET which is the single most important contributory factor in the pathogenesis of COM should be evaluated with the objective method before tympanoplasty.

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

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.

Efficacy of platelet-rich plasma in alleviating split skin graft morbidities.

Skin grafting is a routinely employed technique to cover the skin defect. Though the skin grafts are technically effortless, they are tiresome because of the prolonged duration of hospital stay, labor-intensive, demanding repeated dressings, and also create a second wound. Platelet-rich plasma (PRP) is one that has a higher concentration of platelets than the blood. Alpha granules of the platelets are rich in growth factors. To assess the effect of PRP on split-thickness skin graft uptake and donor site healing. In a single-center-based prospective study done from August 2018 to June 2020, 60 patients with acute and chronic wounds were divided into two equal groups. Autologous PRP was applied on the recipient wound bed and donor site in PRP group, and conventional methods like staples/sutures were used to anchor the skin grafts and standard of care of the donor site in a control group. Instantaneous graft adhesion was observed in all patients of PRP group. The first graft inspection was delayed. Seroma, hematoma, total number of dressings, and duration of stay in hospital were significantly reduced in the PRP group. Donor site pain in the postoperative period was notably reduced in PRP group. PRP also remarkably hastened the donor site healing. The application of PRP promotes graft take, minimizes complications, enhances donor site wound healing, mitigates donor site pain, and has immense economic benefits due to the reduced number of dressing changes and shorter hospital stay.