Large Central Perforation Research Articles

Clip Myringoplasty.

Perforations of the tympanic membrane result mainly from otitis media or trauma, and we need grafting when a perforation is chronically persistent to prevent recurring infections and to enhance hearing. In the present study, we assessed the success rate, feasibility, and efficacy of endoscopic transcanal tympanoplasty using tragal cartilage grafts via the clip technique. This prospective study was performed between September 2017 and December 2021 and was conducted in ENT departments in tertiary hospitals. Forty patients underwent endoscopic clip technique tragal cartilage type 1 tympanoplasty. Patients with dry (for 3 months at least) small (less than 3 mm), medium (3-5 mm), or large (more than 5 mm) central perforations but not marginal perforations. TM perforation healing following the procedure for 6 months was achieved in 100% of the patients with small perforations, 18 of 19 (94.73%) with medium perforations and 11 of 12 (91.6%) with large perforations. At 6 months post-surgery, hearing improvement, as confirmed by audiometric results, was approximately 12.41 ± 1.01 dB. There was a highly significant improvement in the A-B gap (air-bone gap). Endoscopic chondro-perichondrial tragal graft with the clip technique for the repair of small-, medium-, and large-sized nonmarginal TM perforations is a minimally invasive, safe and effective technique compared with the conventional myringoplasty technique. It provided good results (closure of both the perforation and the air-bone gap), minimized morbidity, reduced the operative time, increased patient compliance, and reduced the duration of hospital admission.

Comparative study of endoscopic underlay myringoplasty with or without tucking of the attached perichondrium graft when repairing large central dry perforations

ObjectiveTo compare the graft success rates and hearing outcomes of underlay myringoplasty with or without perichondrium tucking of the attached perichondrium, graft perforation margins when repairing chronic large central dry perforations. Study designRandomized controlled trial. Material and methodsChronic large central dry perforations were prospectively randomized to tucking perichondrium graft underlay (TPGU) and no-tucking perichondrium graft underlay (NTPG) groups. The graft outcomes and complications were compared between the two groups at 12 months postoperatively. ResultsIn total, 61 patients with large central dry perforations were included. All patients completed 12-month follow-ups. Residual perforations occurred in 0.0 % of the TPGU group and in 12.9 % of the NTPG group (P = 0.129), and re-perforations occurred within 6 months in 0.0 % and 3.2 % of the two groups, respectively (P = 0.987). The graft success rates were 100.0 % (30/30) and 83.9 % (26/31) (P = 0.067). No significant between-group differences were observed in terms of preoperative (P = 0.547) or postoperative (P = 0.612) air bone gaps (ABGs) or mean ABG gains (P = 0.597). No graft-related complications were observed in either group during follow-up. No patients exhibited significant graft blunting or medialization; graft lateralization was noted in one patient of the NTPG group. ConclusionsEndoscopic cartilage with tucking of the attached perichondrium perforation margins during underlay myringoplasty may improve the graft success rate compared to that of the cartilage push-through technique when repairing large central dry perforations; however, the hearing improvements were comparable in the two groups.

Status and Depth of Mastoid Antrum and the Pattern of Mastoid Pneumatization in Cases of Large, Subtotal Perforations and Posterosuperior Retraction Pockets (PSRP).

The present study aimed to evaluate the pneumatization status of the mastoid air cells in general with the depth and status of mastoid antrum in particular, in patients of chronic otitis media (COM). This is an observational cross-sectional study in sample size of 60 participants with large, subtotal perforation and posterosuperior retraction pocket (PSRP). Mean age with large central and subtotal perforation combined was 35.78 years, compared to 32.13 years in PSRP. Granulations seen in antrum in 71.6% and cholesteatoma observed in 15%. Mean depth of the mastoid antrum was 17.27 mm. A well pneumatized mastoid in 21.6%, diploic 28.3% and sclerotic in 50% was noted in this study. Chronic otitis media affects temporal bone pneumatization, particularly the mastoid antrum. Our findings indicate that the depth of the mastoid antrum is slightly greater in cholesteatoma cases due to bone erosion. As early intervention enhances postoperative quality of life by preserving or restoring auditory function, understanding the mastoid pneumatization and antrum depth is crucial for managing chronic otitis media effectively.

COMPARATIVE STUDY OF SURGICAL OUT COME OF INTERLAY TYMPANOPLASTY AND UNDERLAY TYMPANOPLASTY IN TERMS OF HEARING IMPROVEMENT AND GRAFT UPTAKE

Introduction: Perforation of the tympanic membrane primarily results from middle ear infections, trauma or iatrogenic causes. Up to 80% of these perforations heal spontaneously; for the remaining, surgical repair, known as myringoplasty, is usually proposed. The principal indications are recurrent otorrhea, the desire to swim without having to waterproof the ear and to improve conductive hearing loss. Several factors may affect surgical outcome such as the surgical approach (endaural, postaural) and technique (underlay vs. overlay), site of perforation and type of graft utilized. Material &Methods: This study was carried out from January 2018 to October 2019. Detailed history and examination were carried out the patient of Chronic Otitis Media with Inactive mucosal disease in large central perforation. Out of 50 patients, 25 patients were operated by underlay technique and rest 25 patients were operated by interlay tympanoplasty. In both the techniques of myringoplasty post auricular approach and temporalis fascia was used as a graft material and operated under general or local anesthesia. Conclusion: Thus in present study as far as resolution of air bone gap is concerned, Interlay technique showed a statistically better outcome as compared to the underlay group. The findings in present study showed a better graft up take in Interlay method which coupled with a better postoperative air bone gap provided a better overall outcome. Key words: Tympanoplasty , Interlay Tympanoplasty, Underlay Tympanoplasty, CSOM,

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.

Correlation Between Pure Tone Audiometry Values and Middle Ear Ossicular Chain Status in Chronic Otitis Media: Study in a Tertiary Health Care Centre.

In this study, we attempt to compare the pure tone audiometry findings with ossicular chain status intraoperatively in patients of chronic otitis media. 102 patients who presented with COM during a period of one year and met the inclusion criteria were included in the study. All patients underwent preoperative pure tone Audiometry and findings were tabulated. All patients were evaluated intraoperatively by the same surgeon and observations were made regarding ossicular chain integrity. Small central perforation was noted in 10%, medium central perforation in 38.57%, large central perforation in 27.14% and subtotal perforation in 24.28%. 71.56% patients had an intact ossicular chain, of which 94.5% was mucosal disease and 5.5% were squamous disease. 29 cases showed eroded/absent ossicles, out of which, 28 had squamous type and 1 case had central perforation. Ossicular status was classified based on Austin Classification. Conductive hearing loss was found to be maximum where all 3 ossicles were eroded/absent, with a mean AB gap of 45.33 and mean air conduction threshold of 60.33. There is a good correlation between the hearing threshold of the patient and the status of ossicular chain. Preoperative knowledge of the degree of hearing loss and status of ossicular chain would allow the surgeon to plan proper ossicular reconstruction and give the patient a better advice regarding prognosis of hearing improvement after surgery.

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.

Comparative Study of Myringoplasty with and without Autologous PRP in Large Central Perforation

Comparative Study of Myringoplasty with and without Autologous PRP in Large Central Perforation

A PROSPECTIVE OBSERVATIONAL COMPARATIVE STUDY FOR POST OPERATIVE RESULTS IN ENDOSCOPIC TYMPANOPLASTY V/S MICROSCOPIC TYMPANOPLASTY

Objective: Chronic suppurative otitis media is a widespread disease in developing countries. Hence treating CSOM with surgical treatment by tympanoplasty is the commonest procedure in ENT practice. In this study we aim to study the advantages and disadvantages of microscopic and endoscopic tympanoplasty. This study also aims to compare the merits and demerits of microscopic and endoscopic tympanoplasty. A Prospective Subjects And Methods: observational study for endoscopic tympanoplasty and microscopic tympanoplasty was conducted on 102 patients of age 20-60 years attending OPD and admissions under the Department of otorhinolaryngology and M.Y.H Hospital, Indore. Subjects with dry central perforation due to CSOM were selected for microscopic tympanoplasty. Similar subjects were selected for Endoscopic tympanoplasty except those with tortuous anatomy of external ear canal. Patients with unsafe CSOM, SNHL, and active infection were excluded. In our study majority (44%) of patients Results: belonged to age group of 25-35 years. Most of the patients were having medium central perforation ( MCP) (32%) followed by subtotal perforation (22.5%). Small central perforation (SCO) 19%, Large central perforation (LCP) 18%, Total perforation 10% respectively. According to quadrant involving perforation which is mainly AIQ, followed by Anterior superior quadrant ( ASQ), Posterior inferior quadrant (PIQ) and posterior superior quadrant (PSQ). Mean operative time for Endoscopic tympanoplasty procedure was 56+/-15 mins with SD of 12.05 and for microscopic tympanoplasty procedure was 117.8+/- 20 mins with SD of 7.17 having a p value (0.0003) which was found to be significant. Conclusion: In our study, we have concluded that endoscopic tympanoplasty scores over microscopic tympanoplasty. Endoscopic tympanoplasty has helped patients achieve faster recovery, a shorter hospital stay, and a lower financial burden, which was especially helpful for developing countries like ours. Unlike the microscope, the endoscope is easily transportable and hence is ideal for use in remote places to conduct ear surgery camps.

Interlay Type-1 Tympanoplasty with or Without Cortical Mastoidectomy in an Inactive Mucosal Chronic Otitis Media with Large Central Perforation: A Retrospective Comparative Study.

The online version contains supplementary material available at 10.1007/s12070-023-03781-7.

A Comparative Analysis of Patients Undergoing Type 1 Tympanoplasty Using Platelet-Rich Fibrin versus Patients Undergoing Conventional Type 1 Tympanoplasty Without the use of Platelet-Rich Fibrin

Aim: The aim of this study was to compare the outcome (graft uptake, success rate, and hearing gain) among patients undergoing type 1 tympanoplasty with and without topical use of platelet-rich fibrin (PRF) over the graft. Materials and Methods: This randomized, prospective, comparative study was conducted among 60 patients divided into two groups: cases and control consisting of 30 patients each, having inactive mucosal Chronic otitis media who underwent type I tympanoplasty with or without cortical mastoidectomy along with the use of PRF for enhancing the graft uptake versus patients who underwent tympanoplasty with or without cortical mastoidectomy without the use of PRF. Results: There was a significant improvement in the uptake of the graft after the use of PRF: 28 (93%) as compared to control 22 (73%). Preoperative and postoperative air-bone gap (A-B gap) was calculated at the end of 1 year and compared, and it was found to be statistically significantly better both in the case and control group (P < 0.05). The improved postoperative success rate in the platelet-rich fibrin-aided type 1 tympanoplasty group emphasizes the presence of growth factors which leads to better healing, with the added benefit of the antimicrobial effect of platelet-rich fibrin. Conclusion: Our results have shown that PRF indeed increases graft uptake, and is a useful adjunct, particularly in large central perforations.

Absent stapedius muscle, tendon and pyramid – An anomaly revisited

Congenital absence of stapedius is an exquisite entity, with an incidence of 0.5% and very few cases reported in live patients. We herein report a case of a middle-aged female presented with bilateral ear discharge and decreased hearing for more than a year, which, on examination, showed a large central perforation bilaterally, and an audiogram preoperatively revealed an average hearing loss of 45 dB and air-bone gap of 35dB bilaterally. Right endoscopic type I tympanoplasty was done, which unveiled absent stapedius muscle, tendon, and pyramid on the right side. The absent stapedius should circumspect the operating surgeon to look for other associated anomalies such as tympanosclerosis, fixed footplate and aberrant course of the facial nerve.

Outcome of Interlay Type 1 Tympanoplasty for Large Central Perforation

Background: Perforation of the tympanic membrane may occur from various reasons. Most of these perforations heal spontaneously, whereas the remaining long-standing perforations that lead to recurrent ear discharge need tympanoplasty. Interlay Type 1 Tympanoplasty,a newer technique has shown promising results with higher success ratein terms of hearing gain and graft uptake.
 Objective: To analyze the results of interlay Type 1 Tympanoplasty in terms of graft uptake and hearing improvement in cases of inactive mucosal chronic otitis media (COM) with large central perforation.
 Methods: This is a prospective study of 24 months (January 2018 to December 2019) duration conducted in department of E.N.T, Khulna medical college, Khulna and data was collected from the 60 patients admitted for tympanoplasty. Results were calculated in terms of graft accepted or rejected and decrease in air bone gap.
 Result: The graft uptake rate in the present study was found to be 91.67% and the patients reported an improvement in terms of hearing. Pre operatively mean air bone gap was 26.5dBand post operatively after 12 weeks mean air bone gap improved to 17.58dB.
 Conclusion: Interlay Type 1 Tympanoplasty is an effective technique over conventional methods in terms of both graft uptake as well as hearing improvement in large central perforation.
 Bangladesh J Otorhinolaryngol; April 2021; 27(1): 86-91

Comparative study of Crescentic Cartilage and Anterior Tucking Tympanoplasty

Introduction: This study was undertaken to know the better technique of two methods i.e. cresentric cartilage tympanoplasty (CCT) and anterior tucking tympanoplasty (ATT) operated by single handed endoscopically. Material and Methods: This study was conducted on hundred patients at Shyam Shah Medical College, Rewa, MP. Hundred patients were selected using certain criteria and fifty patients each were operated by cresentric cartilage supported tympanoplasty(CCT) and anterior tucking technique(ATT). Audiometrically results were analysed preoperatively and postoperatively. Results: Maximum patients affected were teens and males. Maximum patients had large central perforation followed by subtotal and then total perforations in both the groups of cresentric cartilage tympanoplasty (CCT) and anterior tucking tympanoplasty (ATT). We operated under local anaesthesia and some under general anaesthesia in both the groups. Discussion: Hearing being special sense organ needs restoration for normal development and personality grooming. Newer method with evolution of medical sciences have devised techniques of reconstruction of hearing mechanism to give better results. Comparative study using cresentric cartilage tympanoplasty (CCT) and anterior tucking tympanoplasty (ATT) was done to know the better outcome and method. Conclusion: Cresentric cartilage tympanoplasty (CCT) is better of the two methods as it doesn’t shrink or change the shape.

Outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforation: a retrospective comparative study

<p class="abstract"><strong>Background:</strong> Aim and objective were to study the outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforations in terms of graft uptake rate and hearing improvement. </p><p class="abstract"><strong>Methods:</strong> The present study was conducted retrospectively on 110 patients of inactive mucosal chronic otitis media with large central perforation, 55 patients selected from each group undergoing underlay or interlay technique in a tertiary referral hospital, Department of ENT, ESIC Kalaburagi, Karnataka, from February 1 2018 to January 31, 2020. </p><p class="abstract"><strong>Results:</strong> Total 110 patients were included in the study. Male:female ratio was 1:2.2. The age group in this study ranged from 13-50 years of age. Preoperative mean air bone gap in groups A and B was 30.28±6.62, and 30.18±6.87 dB and postoperative mean air bone gap was 19.44±7.66 and 15.13±6.3 dB. In both the groups a significant mean reduction in air bone gap was observed. Mean reduction was maximum in group B. Statistically, intergroup difference in reduction in air bone gap was highly significant (p<0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.</p><p class="abstract"><strong>Conclusions:</strong> Interlay is a better technique than underlay in chronic otitis media inactive mucosal disease with large central perforation in terms of hearing improvement and graft uptake. </p>

A Study of Interlay Grafting in Type 1 Tympanoplasty for Large Central Perforation.

The objective of the study was to study the outcomes of interlay type 1 tympanoplasty in large central perforations in terms of graft uptake, hearing improvement and complications. Study included 150 symptomatic patients having large central perforation in tympanic membrane willing for surgery who later underwent tympanoplasty with or without cortical mastoidectomy. All the patients selected for study, were assessed for subjective and objective evaluation pre-operatively and then post-operatively after 4months. The study was conducted at tertiary health care hospital. Type I tympanoplasty with Interlay technique for large central perforations is superior. The Interlay technique in Type I tympanoplasty has high success both in terms of graft uptake as well as ABG closure. In the view of the advantages it offers, it should be preferred over the other conventional techniques in patients with large central perforations for better results.

Interlay Cartilage Rim Augmented Fascia Tympanoplasty: An Effective Graft Model in Mucosal Chronic Otitis Media.

To study the efficacy of interlay cartilage rim augmented fascia tympanoplasty in mucosal chronic otitis media. A retrospective, observational study was conducted in a tertiary care hospital including charts of patients spanning a duration of one year, where 15 patients diagnosed with chronic otitis media-mucosal disease with large and subtotal perforations (with or without ossicular erosion), and had undergone interlay cartilage rim augmented fascia tympanoplasty, were analysed for morphological and functional improvement following surgery. Pre- and post-operative otomicroscopic examination and pure tone audiometry findings were the parameters considered. 86.6% had a well-healed, non-retracted, undisplaced mobile neotympanum, 6.7% who underwent a type III (minor columella) tympanoplasty had a medialised neotympanum and 1 subject (6.7%) who underwent a type I tympanoplasty had a residual pinpoint perforation which healed with conservative management. The overall morphological success rate was 93.3%. The mean hearing gain following surgery was 20.84dB with a minimum gain of 10dB and a maximum gain of 30dB. The mean air-bone gap closure gain achieved was 19.2dB with a minimum gain of 6.4dB and a maximum gain of 30dB. The interlay cartilage-fascia rim augmentation tympanoplasty is a novel, effective graft model suggested for large and sub-total central perforations. Future randomized studies with a larger sample size could be performed with longer follow-up to assess the outcome of this technique.

Interlay technique type 1 tympanoplasty, an alternative for closing large central tympanic membrane perforation

Background: Type 1 tympanoplasty or myringoplasty is the most frequently performed procedure in the field of otology. Type 1 tympanoplasty is a surgical procedure to repair and only involves the restoration of the perforated tympanic membrane. There are three most accepted methods often used universally, namely underlay, overlay, and interlay. The interlay method is a relatively new method developed in 1992 for closing tympanic membrane perforation. This method has a high success rate of 96%. Objective: To report the success of type 1 tympanoplasty with an interlay method to close large central tympanic membrane perforations at Margono Soekarjo District Hospital. Case Report: Reporting 3 cases of chronic tubotympanic suppurative otitis media with large central tympanic membrane perforation which were repaired by type 1 tympanoplasty using interlay method. Clinical Question: Does interlay method type 1 tympanoplasty performed on large central tympanic membrane perforation provide better result compared with other methods of type 1 tympanoplasty? Review Method: Studying the evidence-based literatures on type 1 tympanoplasty interlay methods through Cochrane, Pubmed, and Google Scholar databases. Based on the inclusion and exclusion criteria, three journals were relevant with the reported cases. Result: All three journals stated that interlay method type 1 tympanoplasty had high success rate in terms of closing the tympanic membrane perforation and diminishing air-bone gap. Conclusion: Type 1 Tympanoplasty interlay method could be used as an alternative for the closure of a large central tympanic membrane perforation.Keywords: Chronic Tubotympanic Suppurative Otitis Media, large central tympanic membrane perforation, interlay tympanoplasty ABSTRAK Latar belakang: Timpanoplasti tipe 1 atau miringoplasti merupakan prosedur di bidang otologi yang paling sering dilakukan. Timpanoplasti tipe 1 merupakan metode pembedahan yang bertujuan untuk memperbaiki, dan terbatas hanya di membran timpani. Terdapat tiga metode yang paling diterima dan sering digunakan secara universal, yaitu underlay, overlay, dan interlay. Metode interlay merupakan metode penambalan perforasi membran timpani yang relatif baru, dikembangkan pada tahun 1992. Metode ini mempunyai keberhasilan yang tinggi yaitu mencapai 96%. Tujuan: Melaporkan keberhasilan timpanoplasti tipe 1 dengan metode interlay untuk penutupan perforasi membran timpani sentral besar di RSUD Margono Soekarjo. Laporan kasus: Dilaporkan 3 kasus otitis media supuratif kronik tipe tubotimpani dengan perforasi sentral besar, yang dilakukan timpanoplasti tipe 1 dengan metode interlay. Pertanyaan klinis: Apakah metode interlay timpanoplasti tipe 1 yang dilakukan pada perforasi membran timpani yang besar, dapat memberikan hasil yang lebih baik daripada metode lain timpanoplasti tipe 1? Telaah literatur: Telaah berbasis bukti mengenai timpanoplasti tipe 1 metode interlay melalui database Cochrane, Pubmed, dan Google Scholar. Berdasarkan kriteria inklusi dan ekslusi didapatkan tiga jurnal yang relevan dengan kasus yang dilaporkan. Hasil: Ketiga jurnal tersebut menyatakan bahwa timpanoplasti tipe 1 metode interlay mempunyai angka keberhasilan yang tinggi dalam hal penutupan perforasi membran timpani maupun mengurangi air-bone gap. Kesimpulan: Timpanoplasti tipe 1 metode interlay dapat digunakan sebagai alternatif untuk penutupan perforasi membran timpani sentral yang besar

A Randomized Prospective Study on Interlay Vs Underlay of Type I Tympanoplasty in Remote Tertiary Center

Background: Type I tympanoplasty is a surgical technique used to restore the integrity of tympanic membrane as well as improve the hearing in inactive mucosal chronic otitis media. There are two main methods that are underlay and overlay in between both is interlay. The aim of the present study is to analyse and compare the results of the two most commonly used type I tympanoplasty techniques, underlay and the interlay technique in chronic otitis media with mucosal disease in large central perforation, in terms of graft uptake and hearing improvement. Subjects and Methods: This is a randomized prospective study of 100 cases of inactive mucosal chronic otitis media with total or large anterior central perforation between October2017 to September 2019 in Anugarah Narayan Magadh Medical College & Hospital, Gaya. Half had gone through Interlay and half by Underlay technique of Type I Tympanoplasy surgery. Results: The graft uptake rate in this study was 96% and 90% for Interlay and Underlay technique respectively. Postoperatively mean air bone gap maximally reduced in the Interlay technique. Conclusion: The present study showed that Interlay method had better graft uptake rate as well as hearing improvement in total and large anterior central perforation of inactive mucosal chronic otitis media than the Underlay technique.

Role of Platelet Rich Plasma in Tympanoplasty.

To compare the efficacy of platelet rich plasma (PRP) in Tympanoplasty. Comparative study of Tympanoplasty with and without PRP. A total of 82 patients having dry large central perforation underwent type I Tympanoplasty by transcanal route under local anesthesia. Control group underwent surgery without PRP. The study group Tympanoplasty was added with PRP by PRP soaked gel foam placed in middle ear, over the graft and in bony canal along with wetting the temporal fascia by PRP graft. Preoperative and post operative audiometry was done. Result compared. Majority of the patients were of the age group of 20-30years. Success rate of graft uptake was 85.3% in control group and 95.1% in PRP group. Hearing Improvements in control group was 46.3% and in PRP group was 78.0%. This study confirms addition of PRP in Tympanoplasty enhances the success rate in graft uptake early healing with improvement in hearing.