Repair Of Tympanic Membrane Perforations Research Articles

Comparison of porcine small intestinal submucosa and autologous graft material for repairing tympanic membrane perforation: a systematic review and meta-analysis.

To perform a systematic review and meta-analysis exploring the effectiveness of porcine small intestinal submucosa(pSIS) compared with autologous grafts for tympanic membrane perforation repair. A prospective meta-analysis protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews) on June 5th, 2024, under protocol CRD42024551979. PubMed, Embase/Ovid and Cochrane Central databases were searched from inception to 28/05/2024 for studies comparing the use of pSIS versus autologous grafts (perichondrium, cartilage, temporalis fascia or cartilage-perichondrium) for tympanic membrane perforation repair. The outcomes evaluated were persistent perforation after surgery, operative time and hearing outcome. Statistical analyses were performed using the online Review Manager (Cochrane Collaboration). A subgroup analyses were carried out for the paediatric population. We included 1,407 patients (1447 ears) from seven records; six retrospective cohort studies and one randomised controlled trial (RCT). pSIS graft was used in 563 ear surgeries (38.1%). Four studies included children with a mean age ranging from 7.3 to 11.7 years and the other 3 studies included adults with a mean age ranging from 30.8 to 48.4 years. Follow-up ranged from 2 to 132 months. There was no statistically significant difference in the failure rate (persistent perforation) between pSIS graft and autologous graft (RR 0.95; 95% CI 0.67-1.33; p = 0.76). However, reduced operative time was associated with using pSIS grafts (MD -16.12min; 95% CI -22.94-9.31; p = < 0.00001). Tympanic membrane perforation repair with pSIS grafts had a similar failure rate and hearing outcome compared to autologous grafts and demonstrated an association with reduced operative time.

Advances in 3D printing for the repair of tympanic membrane perforation: a comprehensive review.

Tympanic membrane perforation (TMP) is one of the most common conditions in otolaryngology worldwide, and hearing damage caused by inadequate or prolonged healing can be distressing for patients. This article examines the rationale for utilizing three-dimensional (3D) printing to produce scaffolds for repairing TMP, compares the advantages and disadvantages of 3D printed and bioprinted grafts with traditional autologous materials and other tissue engineering materials in TMP repair, and highlights the practical and clinical significance of 3D printing in TMP repair while discussing the current progress and promising future of 3D printing and bioprinting. There is a limited number of reviews specifically dedicated to 3D printing for TMP repair. The majority of reviews offer a general overview of the applications of 3D printing in the broader realm of tissue regeneration, with some mention of TMP repair. Alternatively, they explore the biopolymers, cells, and drug molecules utilized for TMP repair. However, more in-depth analysis is needed on the strategies for selecting bio-inks that integrate biopolymers, cells, and drug molecules for tympanic membrane repair.

Interlayer repair with porcine small intestinal submucosa versus internal repair with tragus cartilage in endoscopic tympanoplasty

ObjectiveEndoscopic tympanoplasty includes various surgical methods, such as internal repair, interlayer repair, and external overlay. This technique requires autologous materials, allografts, and xenografts, which are used to repair tympanic membrane (TM) perforation. To obtain good results, appropriate surgical methods and repair materials should be selected. This study aims to assess the efficacy of repairing refractory TM perforations in the porcine small intestinal submucosa (SIS) during transcanal endoscopic type I tympanoplasty. MethodA retrospective chart review was performed on patients who underwent TM perforation repair with porcine SIS and tragus cartilage between January 2022 and September 2022 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Perforation size, tympanic status, pre- and postoperative symptoms, follow-up data, wound healing rates, and hearing improvement were analysed. ResultsOf the 115 patients included in the study, 56 underwent interlayer repair with porcine SIS of the TM, and 59 patients underwent internal repair with tragus cartilage. No significant difference was found between the two groups at baseline in terms of age, sex, disease course, perforation side, tympanic status, underlying disease, or preoperative infection. The total postoperative effective rate of interlayer implantation with porcine SIS was 91.07% (51 patients), and that of internal implantation with tragus cartilage was 88.14% (52 patients). No significant difference was found in terms of the graft success rate between the two surgical methods (p = 0.887). Postoperative pure tone auditory (PTA) and air-bone gap (ABG) density significantly increased in both groups compared with before surgery (p < 0.05). However, the postoperative PTA and ABG density were not significantly different 3 months post-surgery between the two groups (p > 0.05). Compared to those in the internal implantation group, the patients in the interlayer group had a shorter operation duration (51.36 ± 6.76 min vs. 59.71 ± 7.45 min, t = 6.298, p < 0.001) and less blood loss (11.91 ± 2.61 mL vs. 15.27 ± 2.57 mL, t = 7.019, p < 0.001). ConclusionsOur study suggests that the porcine SIS, as well as the tragus cartilage, has a high success rate in repairing irreversible TM perforation. Endoscopic tympanoplasty via interlayer implantation with porcine SIS offers distinct advantages, including the absence of donor-site incision and scar formation, and ease of graft modification and manipulation.

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.

Chronic tympanic membrane perforation repair with a collagen-based scaffold: An in vivo model

ObjectiveThe aim of this study was to assess the in vivo efficacy of a novel regenerative collagen-based scaffold developed by the Royal College of Surgeons in Ireland in a chronic tympanic membrane perforation (TMP) using a chinchilla model. MethodsBilateral TMPs were induced in 17 mixed gender chinchillas using tympanic membrane resection followed by a mixture of topical Mitomycin C and dexamethasone for 3 days. These were monitored with weekly otoscopy for 8 weeks. Animals were excluded if signs of infection developed in the follow up period (n = 8). At 8 weeks, intervention began and 18 TMPs were assigned to either treatment with the collagen-based scaffold (treated group) or spontaneous healing (control group). Animals were euthanized 6 weeks post-intervention. Otoscopic imaging and auditory brain response (ABR) were conducted at baseline, 8 weeks post-TMP induction and 6 weeks post-intervention. All TMPs were then evaluated at 6 weeks post-intervention and bullae underwent histologic evaluation. ResultsAt 6 weeks post-intervention, otoscopic imaging demonstrated various degrees of healing in the treated ears. The treated group was noted to have an increased rate of healing when compared to the control group. Histologic evaluation demonstrated a variation in the degree of perforation healing within groups, with some animals in the treated group showing high levels of perforation healing. At 8 weeks after the TMP procedure, most of the animals had worsened hearing response. At 6-week post the collagen-based scaffold treatment, about 50 % (4/8) of the treated ears had improved in hearing response as compared to those of non-treated ears. ConclusionGiven the initial histologic evidence of partial healing in scaffold-treated ears, the post-intervention period should be extended to monitor the potential for complete healing. Given the overall positive findings related to healing with the scaffold-treated ears, this material warrants further investigation.

Does myringosclerosis affect the success of butterfly myringoplasty?

ObjectivesButterfly inlay myringoplasty is a simple and practical surgical technique used in the repair of tympanic membrane perforation offering good outcomes in terms of hearing. The present study evaluates the effects of myringosclerosis on the success of surgery by reviewing demographic data, perforation size and hearing outcomes of patients undergoing endoscopic inlay butterfly myringoplasty due to chronic otitis media. MethodsThe study included 75 patients who underwent endoscopic inlay butterfly myringoplasty with the diagnosis of chronic suppurative otitis media in the Department of Otorhinolaryngology at Fırat University Faculty of Medicine between March 2018 and July 2021. The patients were divided into three groups as the following. Group I: Patients without a myringosclerotic focus in the neighborhood of tympanic membrane perforation, Group II: Patients with a less than 50% myringosclerotic focus in the neighborhood of tympanic membrane, and Group III: Patients with a more than 50% myringosclerotic focus in the neighborhood of tympanic membrane. ResultsThe comparison of all preoperative and postoperative parameters and the reduction in air-bone gap between the groups did not show statistically significant difference (p>0.05). The comparison of air-bone gaps between preoperative and postoperative measurements showed a statistically significant difference in all groups (p<0.05). The grafting success rate was 100% in Group I, 96.4% in Group II, and 95.6% in Group III. The mean operation time was 28.57±2.54 min in Group I, 32.14±2.44 min in Group II, and 30.69±3.43 in Group III; there was a statistically significant difference only between Group I and Group II (p = 0.001). ConclusionsThe graft success rate and hearing gain in patients with myringosclerosis were similar to those in patients without myringosclerosis. Therefore, butterfly inlay myringoplasty is applicable to patients with chronic otitis media regardless of the presence or absence of myringosclerosis.

A novel technique in treatment of advanced tympanosclerosis: results of malleus replacement and loop prostheses combination; pure endoscopic transcanal approach.

The objectives of the present clinical trial are to describe our surgical technique for advanced tympanosclerosis (TS) and to present the comparison of pre-and postoperative audiometric results. 21 patients suffering from advanced TS (Only type III and IV patients according to Wielinga-Kerr classification) were enrolled in this prospective study. A pure transcanal endoscopic approach was preferred for all patients included in the study. Titanium malleus replacement prosthesis (MRP) and polytetrafluoroethylene (PTFE) loop prosthesis combination were used to bypass fixed ossicles to achieve sound transmission to the inner ear. Pre-and postoperative pure tone audiometry (PTA) measurements and air-bone gap (ABG) results compared, and surgical technique was considered successful if postoperative ABG was less than 20dB. Six of the 21 patients had been operated on before and the tympanic membrane (TM) was intact. The remaining 15 of the 21 patients were the primary cases, and TM perforation repair and ossiculoplasty using combination of the MRP and PTFE loop prosthesis were performed at single-staged operation. The average preoperative ABG values significantly improved from 37.1 ± 6.2 to 14.5 ± 1.2dB postoperatively (p < 0.001). The mean preoperative air conduction threshold (ACT) significantly decreased from 51.7 ± 11.4 to 28.5 ± 9.1dB (p < 0.001). TS surgery is still a controversial issue particularly in stapes footplate fixation. However, our surgical and audiological results in this study are quite promising. The combination of titanium MRP and PTFE loop prosthesis for restoring sound transmission in advanced TS cases is reliable, effective and novel treatment option via endoscopic transcanal approach.

Anatomic and audiometric outcomes of porcine intestinal submucosa for tympanic membrane repair.

Surgical repair of tympanic membrane perforations has been traditionally performed with autologous soft-tissue grafts with high success rates. Newer allografts such as porcine small intestine submucosa (pSIS) have been employed as alternatives to minimize donor morbidity and surgical time, and in cases where autologous tissue may not be available. The comparative anatomic and audiometric success rates of these tissues is still unclear. Retrospective case-control series of anatomic and audiometric outcomes of autologous soft tissue versus pSIS graft for primary, isolated transmeatal tympanic membrane repair. Analysis of patients undergoing primary transmeatal tympanic membrane repair with autologous soft tissue or pSIS. Patients with otorrhea, cholesteatoma or retraction pockets, those who had cartilage grafts or ossicular reconstruction, and revision procedures were excluded. Pre- and post-surgery air-bone gaps (ABG) and pure tone averages (PTA) were compared. Graft success was defined as closure of the perforation at 2-month follow-up visit. The success rate for both the autologous soft tissue and the pSIS arm is 93.8%. There was no statistical significance (p< .05) between the post-op ABG, change in ABG, post-op PTA, change in PTA, or graft success rate between the two groups with either lumped cohort or matched-pairs analysis. pSIS grafts are effective for repair of tympanic membrane perforations with hearing outcomes and graft success rates comparable to autologous soft tissue. Repair of tympanic membrane perforations is traditionally done using a soft-tissue graft harvested from the patient at the time of surgery. pSIS is a newer graft material that is equally effective in terms of anatomical and audiometric outcomes. Level 3b.

Silk fibroin nanofiber scaffold (SFNS) as a graft material for myringoplasty- in vitro and in vivo

Tympanic membrane (TM) perforation repair or myringoplasty is one of the most common surgeries performed in ENT practice. This surgery uses graft materials such as temporalis muscle fascia, pinna cartilage, perichondrium, and even artificial materials such as silicone and polymers to restore the hearing mechanism in deaf people and stops ear discharge. Some disadvantages of this surgery include the requirement for complex microsurgical skills, high cost, graft site complications, and anesthesia-related risks. To overcome these drawbacks, a variety of bioengineered graft materials, such as polycaprolactone (PCL), silk polymers are being used. In this study, we used in vitro and in vivo investigations to assess the potential use of silk fibroin nanofiber scaffolds (SFNS) as a graft material. Cell proliferation, viability studies and DNA quantification tests were performed on rat primary TM epithelial cells and human mammary fibroblast (HMF) cells to evaluate SFNS in vitro. The results demonstrated that both rat primary TM epithelial cells and HMF cells are compatible with SFNS graft material and showed cell proliferation. The scanning electron microscopy (SEM) was used to image the rat primary TM epithelial cells on SFNS and found the cells integrated into SFNS, proving that the graft material is nontoxic. The in vivo experiments included creating TM perforations in Sprague Dawley rats and performing myringoplasty with SFNS as a graft. Five out of six rats demonstrated effective perforation healing, including evidence of neovascularization at the pars tensa, indicating that the SFNS is biocompatible and can be employed for TM perforation repair.

Outcomes of Endoscopic Myringoplasty

Introduction: The endoscope has diagnostic and therapeutic role in different otological surgeries. It has excellent view of images where there are difficult nooks and corners. The use of tragal cartilage in the repair of tympanic membrane perforation has its own benefit in graft uptake and hearing results whether long term or short term. The main purpose of the present study was to evaluate the long‑term hearing results in patients who underwent endoscopic sandwich myringoplasty with National Medical college &amp; Teaching Hospital, Birgunj. Objective: To evaluate the graft success rate and postoperative hearing gain for central perforations using endoscopic myringoplasty Materials and Methods: This study is a prospective study in 60 patients with central perforations who underwent endoscopic myringoplasty using tragal cartilage. The hearing was assessed by comparing pre‑. with post‑operative air‑bone gap (ABG) and ABG closure in speech frequencies (0.5 kHz, 1 kHz, 2 kHz, and 4 KHz). Results: Of the 60 patients with central perforation included in this study, the graft success rate was 95% (57/60). The graft uptake in 6 months of follow‑up. The postoperative ABG (13.77 ± 4.94dB) was lesser than preoperative ABG (22.38 ± 6.93 dB) with statistically significant results. Conclusion: Endoscopic myringoplasty is a safe procedure with high‑graft uptake rate and good long‑term hearing results.

Impact of cubism graft on the outcome of tympanoplasty surgery

Background: Tympanoplasty is a widely performed surgery for the repair of tympanic membrane perforation. Aim of the study: to compare the auditory and anatomical outcomes between two different techniques in tympanoplasty: the first with temporalis facia graft + the new “cubism” graft and the other with temporalis facia graft alone. Patients and methods: A prospective, randomized study was conducted in Otorhinolaryngology Head and Neck Surgery Department, Al-Azhar University Hospital (Damietta). Results: Cubism graft group wasn't significantly different to Temporalis fascia only group regarding ABG (p= 0.233). The ABG gain 3 month in Cubism graft group ranged from 14 to 17.5 with mean ± SD = 16.17 ± 1.15 while in Temporalis fascia only group the ABG gain 3 month ranged from 10 to 16 with mean ± SD = 14.12 ± 1.91 with statistical significant difference (p= 0.005) between the two groups. Conclusion: The novel “cubism” graft technique offers many advantages. Cartilage grafts can be thinned harmlessly while obtaining a convenient additional material in this technique. This hybrid, cartilaginous dust and PRF mixture graft can be used widely in tympanoplasty. We experienced that both functional and anatomical outcomes of this graft are very satisfying.

Current variations and practice patterns in tympanic membrane perforation repair.

Management of tympanic membrane perforations is varied. This study aimed to better understand current practice patterns in myringoplasty and type 1 tympanoplasty. An electronic questionnaire was distributed to American Academy of Otolaryngology - Head and Neck Surgery members. Practice patterns were compared in terms of fellowship training, practice length, practice setting, paediatric case frequency and total cases per year. Of the 321 respondents, most were comprehensive otolaryngologists (60.4 per cent), in private practice (60.8 per cent), with a primarily adult practice (59.8 per cent). Fellowship training was the factor most associated with significant variations in management, including pre-operative antibiotic usage (p = 0.019), contraindications (p < 0.001), approach to traumatic perforations (p < 0.001), use of local anaesthesia (p < 0.001), graft material (p < 0.001), tympanoplasty technique (p = 0.003), endoscopic assistance (p < 0.001) and timing of post-operative audiology evaluation (p = 0.003). Subspecialty training appears to be the main variable associated with significant differences in peri-operative decision-making for surgical repair of tympanic membrane perforations.

Endoscopic tympanoplasty type I using interlay technique

BackgroundTympanoplasty using the interlay technique has rarely been reported in transcanal endoscopic ear surgery, unlike the underlay technique. This is because many surgeons find it challenging to detach the epithelial layer of the tympanic membrane using only one hand. However, the epithelial layer can be easily detached from the inferior part of the tympanic membrane. Another key point is to actively improve anteroinferior visibility even if the overhang is slight because most perforations and postoperative reperforations are found in the anteroinferior quadrant of the tympanic membrane. We report the application of the interlay technique in endoscopic tympanoplasty type I for tympanic perforations.MethodsWe retrospectively reviewed the medical records of 51 patients who had undergone tympanoplasty using the interlay technique without ossiculoplasty between 2017 and 2020. We then compared the data with those of patients who underwent microscopic surgery (MS) using the underlay technique between 1998 and 2009 (n = 104). No other technique was used in each group during this period. Repair of tympanic membrane perforation and hearing outcomes were assessed for > 1 year postoperatively.ResultsThe perforation sites were limited to the anterior, posterior, and anterior–posterior quadrants in 23, 1, and 27 ears, respectively. Perforations were closed in 50 of the 51 ears (98.0%), and the postoperative hearing was good (average air-bone [A-B] gap was 6.8 ± 5.8 dB). The surgical success rate for the repair of tympanic membrane perforation was not significantly different from the MS group (93.3%, P = 0.15). The average postoperative average A-B gap in the group that underwent the interlay technique was significantly different from that in the MS group (10.1 ± 6.6 dB, P < 0.01).ConclusionThe interlay technique should be considered as one of the treatment methods in endoscopic surgery for tympanic perforations. Further study of the postoperative outcomes of this procedure should be conducted to establish the optimal surgical procedure for tympanic perforations.Trial registration: This study was retrospectively approved by the Institutional Review Board of the Jikei University, Tokyo, Japan (approval number: 32-205 10286).Video abstractEHU69PToR4KkpCPbQtPHKeVideo abstract

In-Office Repair of Tympanic Membrane Perforation.

In-Office Repair of Tympanic Membrane Perforation.

In office repair of tympanic membrane perforations

Tympanic membrane (TM) perforations commonly occur as a result of chronic ear infections, direct trauma or blast injuries, as seen in military and civilian populations following terror attacks. TM perforations result in considerable morbidity, including hearing loss, pain, recurrent infections and decreased quality of life. Repair of chronic TM perforations is typically performed in the operating room under general anesthesia. Recently developed techniques for TM repair afford the option to manage patients in the clinic setting. Herein we describe our endoscopic approach for in-office, awake TM repair and review patient selection, instrumentation, technique and postoperative management. We also discuss outcomes from a cohort study including closure rates, hearing outcomes and patient reported outcome measures. Tympanic membrane perforation, tympanoplasty,in-office ear surgery, endoscopic ear surgery

Different Grafts used In Closure of Central Small Tympanic Membrane Perforations

Background: Large number of patient seek ENT consultation for central perforation of tympanic membrane. A significant portion of these cases are often found with very small central perforation. Minimyringoplasty is a very simple procedure to close such small perforations. Objective: the aim of the present study is to compare the surgical and audiological results of temporalis fascia versus more simple methods ( fat graft, fat graft wih hyaluronic acid and platelet rich plasma)in myringoplasty. Patient and Methods: a randomized prospective study concerned with 80 patients for whom myringoplasty was done. Patients were randomly assigned into four groups; in the first group fat graft was used (20patient) and fat graft with hyaluronic acid was used in the second group (20 patients).and platelet rich plasma was used in third group (20 patients) and temporalis fascia was used in fourth group (20 patients). Results: our study included 80 patients, 45 males and 35 females with a range from 18- 55 years. Surgical success rates75% , 80%, 75%and 75%for fat graft, fat graft with hyaluronic acid, platelet rich plasma and temporalis fascia respectively. There was 6.5 dB, 7db , 6 db and 5.5 db mean hearing improvement improvement in fat graft, fat graft with hyaluronic acid, platelet rich plasma and temporalis fascia respectively. Conclusions: The myringoplasty with fat graft,fat graft with hyaluronic acid and PRP is a minimally invasive effective procedure in management of the small central tympanic membrane perforations . Also it is safe and feasible procedure In this study we have achieved High success rate of repair of tympanic membrane perforation.

Comparison between Outcome of Myringoplasty with and without Ensuring the Patency of Aditus ad Antrum

Background: Myringoplasty is a technique for the closure of the simple perforation of the tympanic membrane. For the better outcome, myringoplasty combined with cortical mastoidectomy has been tried in many studies. Objectives: To compare the outcome of repair of tympanic membrane perforations with myringoplasty alone versus myringoplasty with opening of blocked aditus if any by doing antrostomy. Methodology: This was a prospective study. Patients included in the study were randomly allocated into 2 groups, the group I and the group II. The group I included 17 patients undergoing myringoplasty with antrostomy and the group II included 17 patients undergoing only myringoplasty. The blocked aditus was made patent if it was found blocked during antrostomy procedure. Graft uptake rate and improvement in conductive hearing loss were measured as success rate. Results: Mean age of the patients in the group I was 23.12 ± 7.55 years. The mean age of patients in the group II was 25.53 ± 8.79 years. In the group I unilateral disease was present in 6 (35%) cases. In the group II unilateral disease was present in 12 (70.5%) cases. In the group I subtotal perforation was present in 9 (52.9%) cases and moderate to large perforation was present in 8 (47%) cases. In the group II subtotal perforation and moderate to large perforation were present in 9 (52.9%) and 8 (47%) cases respectively. Aditus was found to be blocked in eleven (64.7%) patients in the group I. Successful graft uptake was seen in twelve cases (70.58%) in the group I and eleven cases (64.7%) in the group II with all of them showing improvement in hearing. The success rate of the group I was 70.58% while success rate of the group II was 64.7%. The mean of pre-operative and post-operative air-bone gap was 31.94 ± 11.7 dB and 24.8 ± 10.55 dB respectively in the group I with the mean hearing gain of 7.06 ± 3.9 dB. Similarly, the mean of pre-operative and post-operative air-bone gap was 28.24 ± 10.5 dB and 17.9 ± 0.08 dB respectively in the second group with the mean hearing gain of 10.29 ± 4.83 dB. Conclusion: There was no difference between success rate of myringoplasty with antrostomy group and myringoplasty alone group in the treatment of mucosal tympanic membrane perforation; however in majority of cases where aditus patency was checked (group I) it was found to be blocked (64.7%).

Effectiveness of underlay myringoplasty in inactive mucosal chronic otitis media; a prospective study

Introduction: Patients with a mucosal type of chronic otitis media (COM) usually have recurrent ear discharge and conductive hearing loss. It is characterized by the central perforation of the tympanic membrane. Myringoplasty is an operation performed to repair tympanic membrane perforation when there is no ossicular damage. It helps to prevent ear discharge and improves hearing. Different techniques used for myringoplasty are underlay and overlay. Underlay technique is an effective procedure for tympanic membrane repair. Methods: 125 patients who underwent underlay myringoplasty over two years in a tertiary care center in Kerala were included in the study. Patients with actively discharging ears were excluded from the study. Results: The majority of the patients were in the age group of 20-29 years (49.6%). There were 47 males (37.6%) and 78 females (62.4%). In 63 patients the surgery was done on the right side (50.4%) and in 62 patients on the left side (49.6%). Maximum preoperative hearing loss was in the range of 30-34 dB (39.2%). 100 patients (80%) showed successful graft uptake with the improvement of hearing in the range of 10-15 dB. Eight patients (6.4%) showed small residual perforation with the improvement of hearing. In 17 patients (13.6%) there was a complete rejection of graft with continuous ear discharge and no improvement in hearing. Conclusion: Underlay myringoplasty is an effective surgical technique for the repair of tympanic membrane perforations in terms of graft take up and improvement of hearing.

Efficacy of Platelet-Rich Plasma on Fat Grafts in the Repair of Tympanic Membrane Perforations

Efficacy of Platelet-Rich Plasma on Fat Grafts in the Repair of Tympanic Membrane Perforations

A STUDY OF SUCCESS RATE OF BUTTERFLY TECHNIQUE

The use of Tympanoplasty as a remedy for minor perforations is a common trend these days. The technique is in use even from ancient time utilizing those day tools. Common criticism on this technique is that it bring disadvantages such as hospital stay, increased morbidity, and post-operative scar. Therefore, there was requirement to bring a more comprehensive technique. In this study, our objective is to assess the clinical and audiometric success rate of new tragal cartilage plug or butterfly technique tympanoplasty. The study is based on 30 patients who were in age category of 16 to 55 years of age. The results shows that out of 30 patients, 27 patients were based on graft taken up; while, the rest of the 3 patients showed residual perforation with an overall success rate of 90%. The anatomical success was assessed by otoscopy with graft well set in place. The functional success was analyzed by audiogram, which showed decrease in Air-Bone (A-B) gap in 25 patients (83.3%). Our conclusion is that the tympanoplasty method may be considered as an alternative treatment option for repair of tympanic membrane perforations.