Temporalis Fascia Research Articles

Pediatric myringoplasty: A study of effectiveness and influencing factors

ObjectivesUntil today, there is no consensus about the ideal age for a myringoplasty in children. In this retrospective study, we study our own series to characterize different prognostic factors to answer questions/dilemmas such as when to carry out surgery in a child with an ear drum perforation, when to postpone surgery or when to use a different technique to improve the outcome after tympanoplasty. MethodsWe performed a retrospective study on charts of 97 children who underwent a myringoplasty. The same surgeon (IF) treated all included children and with the same classical surgical technique: retro-auricular approach and microscopic underlay placement of fascia of the musculus temporalis. Children with associated disease (cholesteatoma, revision surgery and ossicular chain defects) were excluded. All children had a minimum follow up of 12 months. A successful procedure was defined as a closed eardrum after 12 months and an air bone gap <20 dB. Prognostic factors were inventoried and studied. ResultsSuccess rate after myringoplasty is 80.2% in this pediatric case series. Age was not a statistical significant prognostic factor. Only the history of an adenoidectomy had a positive effect on tympanic closure (p = 0.047). A negative prognostic factor was the size of the perforation: large perforations showed only 42.9% eardrum closure (p = 0.040). There was a complication rate of 28.9%, in which formation of granulation tissue and ear discharge were most common but easily treated. ConclusionTympanoplasty type 1 with musculus temporalis fascia in underlay is a safe and successful technique in children of all ages with eardrum perforations. Our data suggests using a different technique (cartilage tympanoplasty) in cases with large perforation. Postponing surgery is not advocated, unless perhaps in children with poor Eustachian function or adenoidhyperplasia.

Nasal Septal Perforation Closure by "Sandwich Grafts": Technique, Initial Results.

Nasal septal perforation closure represents a considerable surgical challenge. Many techniques rely on the implantation of foreign materials that pose a persisting threat of infection. The authors have identified a reliable technique closing septal perforations by an autologous "sandwich graft." It is layered around a piece of auricular cartilage, covered with temporal fascia, thus emulating the physiological layers of the nasal septum. Finally, the prepared graft is then sewn into the perforation in an underlay technique and kept in place by septal splints for 4 weeks. The technique is easily feasible and strives to reconstruct the nasal as physiological as possible. The data obtained from a case series of 11 patients highlights the efficacy of the technique.

Comparison of Reinforcement Cartilage Graft and Temporalis Fascia Graft in Type 1 Tympanoplasty

Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge and perforation. It is the commonest ear problem in adult and children. Most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. Inactive mucosal variety of COM presents with the perforation in tympanic membrane with non-inflamed middle ear mucosa. The treatment of inactive mucosal variety of COM is Type 1tympanoplasty. It can be done by conventional temporalis fascia or cartilage graft. Both have some merits and demerits. Objective: To compare the the outcomes between reinforcement cartilage graft and temporalis fascia graft in type -1 tympanoplasty. Methods: 86 (43 patients in each group) patients with COM (inactive mucosal) who were admitted in the department of Otolaryngology – Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2018 to June 2019, and had fulfilled the inclusion and exclusion criteria were selected for the study. History, examinations, investigations were done. All patients underwent type 1 tympanoplasty. Prior to surgery relevant investigations were done and informed written consent was taken from all patients. In Group-A reinforcement cartilage tympanoplasty cases and in Group-B temporalis fascia tympanoplasty cases were placed. Post-operative graft uptake rate and hearing gain were compared in two groups Results: The surgical outcomes between reinforcement cartilage tympanoplasty in comparison with temporalis fascia tympanoplasty showed no significant difference of graft uptake rate and hearing gain. Conclusion: Cartilage tympanoplasty has been practised for reconstruction of perforated tympanic membrane in COM since long with variable results. Graft uptake rate in cartilage reinforcement is comparatively better than temporalis fascia graft. So, reinforcement cartilage graft can be adopted as an alternative to temporalis fascia graft in type- I tympanoplasty. Bangladesh J Otorhinolaryngol 2021; 27(2): 104-110

Pediatric tympanoplasty: A paradigm shift?

Introduction and objectivesPediatric tympanoplasty is still a matter of controversy. Many factors have been associated with the surgical outcome of tympanoplasty in children, including age, size and location of the perforation, surgical technique and Eustachian tube dysfunction. The optimal approach and timing of this surgery remains controversial.This study aims to evaluate the outcomes of pediatric tympanoplasty and analyze factors that may influence the success of this surgery. Materials and methodsA retrospective review was conducted which included children from 5 to 15 years old that underwent tympanoplasty with or without ossiculoplasty for chronic tympanic perforation in a tertiary care university hospital over a 6-year period. Patients were divided in two age groups (5 to ≤10 years old and >10 to 15 years old). Children with cholesteatoma or that underwent simultaneous mastoidectomy were excluded. Results83 cases were included. Average age was 10.7±2.1 years and mean follow-up time was 9 months. Of the cases, 21.7% were revision surgeries. Successful closure of the tympanic membrane perforation was achieved in 76.9% of primary surgeries and 55.6% of revision surgeries. Most of the patients improved their conductive hearing-deficit. No statistical difference in graft failure was noted regarding age, presence of craniofacial dysmorphism and surgical approach. The use of simple graft (temporal muscle fascia or tragus perichondrium) was significantly superior in primary surgery (p<0.05). We also found a significant difference between the location of the perforation and revision surgery, with anterior perforations showing a higher risk (p<0.05). ConclusionsPediatric tympanoplasty is effective in repairing chronic tympanic perforations. In our study, accepted predictors of surgical outcome such as age and surgical approach were not associated with graft failure.

Aesthetic Design of Expanded Bilateral Superficial Temporal Vascular Fascial Pedicled Flap for Repairing Maxillocervical Scars.

Large-scale maxillocervical scars impair face and neck function and damage appearance. The forehead expanded bilateral superficial temporal pedicled flap is a good treatment strategy for this area; however, the traditional cutaneous pedicled flap damages the temporal hair area. This impairs aesthetics and causes alopecia; furthermore, requires an additional pedicle-cut operation. A retrospective study was performed on 7 patients with large-scale maxillocervical scars from January 2014 to August 2018. Forehead expanders were implanted in the first-stage operation for all patients. After the injection and rest period, patients were treated using the forehead expanded bilateral superficial temporal vascular fascial pedicled flap. Superficial temporal vascular fascia pedicles were carefully harvested. The use of an intralesional or hidden retrotragus incision was determined by the presence of a preauricular scar. Patient satisfaction with postoperative neck activity and the incision scar was evaluated. Intralesional and retrovagus incisions were used in 4 and 3 cases, respectively. One flap developed hematoma, which recovered completely after conservative treatment; all other cases had no complications. All flaps healed well. The neck mobility of the patients was significantly improved with no visible scar in the temporal region. Six cases reported being "very satisfied" and one was "relatively satisfied" with their improvement in neck mobility. All cases reported being "very satisfied" with frontotemporal morphology. The forehead expanded bilateral superficial temporal vascular fascial pedicled flap is a good choice for patients with large-scale maxillocervical scars. This technique can maintain the aesthetics of temporal hair and reduce patients extra surgical injury.

Surgical Considerations for an Osseointegrated Steady State Implant (OSIA2®) in Children.

Surgical Considerations for an Osseointegrated Steady State Implant (OSIA2®) in Children.

The application of a retrograde postauricular island flap in reconstructing periorbital region defects

Reconstruction of periorbital region defects is thought to be one of the most challenging areas in reconstructive plastic surgery. This paper describes our experiences with the application of retrograde postauricular island flaps in reconstructing periorbital region defects. Between November 2008 and June 2019, 16 patients with periorbital region defects underwent treatment using a retrograde postauricular island flap. The flap is designed with two portions: 1) the pedicle segment only with the superficial temporal fascia and 2) the flap segment in the posterior auricular region with non-hair-bearing full-thickness tissue. Intraoperatively, the vascular networks between the postauricular and the superficial temporal vessels were preserved. The flap was then transferred to the receipt area after passing through a subcutaneous tunnel. The donor site was directly closed in the postauricular sulcus by advancing the posterior scalp flap. All the periorbital region defects were reconstructed in one-stage surgery. All the flaps survived without venous congestion. The size of the harvested flaps varied from 5.0×2.5cm to 7.5×5cm. The colour of the transferred flaps matched the surroundings of the receipt region, and the eyelids functioned well. A retrograde postauricular island flap is a good choice for the reconstruction of periorbital region defects. The flap can be useful for the reconstruction of the periorbital region, since it uses similar colours and textures. In addition, it permits a "one-stage" reconstruction with less conspicuous donor site scars behind the auricle.

A Comparative Study on Outcomes of Type 1 Underlay Tympanoplasty with and Without Anterior Tucking of Temporals Fascia Graft.

Tympanoplasty is a surgical procedure which includes eradication of disease from the middle ear and reconstruction of the hearing mechanism with or without tympanic membrane repair. The purpose of this article was to compare the clinical and audiological outcomes of Type 1 underlay tympanoplasty with or without anterior tucking of the temporals fascia graft. This is a prospective interventional study which included 100 patients between 15 and 60years of age, diagnosed with chronic otitis media, mucosal disease inactive stage. 100 patients were divided into two groups 50 each, who underwent type 1 underlay tympanoplasty, group A underwent anterior tucking of the temporals fascia graft and group B without anterior tucking of the temporals fascia graft. Analysis of data was made of the demographic details, graft uptake status and audiological outcomes following surgery. Among the 100 patients included in the study, majority were seen between 21 and 40years of age group. In our study successful graft uptake was seen in 93.4% in group A temporalis fascia with anterior tucking which was better than group B which showed 84% results. However hearing outcome was almost similar in both the groups. In conclusion, graft uptake in tympanoplasty with anterior tucking was found to be better than without anterior tucking. There is significant hearing improvement following underlay technique of tympanoplasty both with and without anterior tucking. There is no significant difference in the hearing improvement with anterior tucking when compared to without anterior tucking of the temporalis fascia graft.

Autogenous Fat as an Ideal Interpositional Material in Temporomandibular Joint Surgery.

Interpositional gap arthroplasty has established itself as the the standard surgical treatment of Temporomandibular joint (TMJ) ankylosis. The autogenous tissue has replaced the alloplastic and other xenografts materials owing to its bioavailability, easy uptake, and no additional cost. Commonly used autogenous tissue has been temporalis muscle and fascia, fascia lata, skin graft, auricular and costal cartilage, the masseter and/or medial pterygoid muscle. With the turn of the century, TMJ surgeons started using autogenous fat from the lower abdomen and today it has taken over as the most favored autogenous filler material in TMJ ankylosis surgery or total joint replacement (TMJ-TJR). The use of buccal fat pad (BFP) has increased in the last decade due to its local availability and pedicled nature. This paper will discuss various autogenous tissues used in interposition and bring forth the journey of the autogenous fat as the preferred interpositional material now and rest the case in its favor.

Deep Subfascial Approach as an Alternative to Explore Temporomandibular Joint: A Pilot Study

Statement of the problemThe study aimed to compare the efficacy of superficial, subfascial, and deep subfascial approaches in patients with temporomandibular joint (TMJ) disorders and to correlate its effect on facial nerve function and quality of the surgical field. Materials and methodsThe study comprised of 15 cases indicated for TMJ surgery divided randomly into 3 study groups: Groups I, II, and III based on the surgical approach used (Figure 1). In Group I patients, the superficial approach was used and dissection was limited to the superficial layer of temporalis fascia. In Group II, a subfascial approach was used where dissection was carried between the 2 layers of the fascia. In Group III, a deep subfascial approach was used where dissection was kept between the deep layer of fascia and muscle. Intraoperatively, the quality of surgical field was assessed using Fromme, et al. Scale and intraoperative blood loss were calculated for each group. The dissection time was measured as the time elapsed from the skin incision to reach the dissection plane. All patients were evaluated for pain and swelling on the first, third, and seventh postoperative day. The facial nerve function test was performed post-surgically after 24 hours, 1 week and 1, 3, and 6 months using the House-Brackman scale. Methods of data analysisStatistical analysis was performed using SPSS software (IBM Corp, Armonk, NY). Data were presented as mean and appropriate. Statistical tests were applied. ResultsThe inter-group comparison showed that the outcomes of all intraoperative parameter were superior in Group II in comparison to the other groups (Table 1), whereas postoperative pain and swelling and facial nerve function were better in Group III (Table 2). Outcomes dataThe mean time required for exposure of TMJ was least in Group I as compared to the other groups (mean score for Groups I, II, and III, respectively, 20.8 ±1.36;19.0±3.3.17; and 29.2±4 minutes). The quantity of blood loss was minimum in Group II (mean score for Groups I, II, and III, respectively, 311.8±5.15; 244.4 ±6.19; and 249.6±10.58). Similarly, the quality of the surgical field was highest in Group II (mean score for Groups I, II, and III, respectively, 2.2±0.87;1.00±0.44; and 1.04±0.33). Mean pain scores were generally better for Group III when compared to Groups I and II on all days. Highest mean score observed on the first postoperative day was 5.2±1.33; 6.2±1.17; and 4.8±1.16 for Group I, Group II and Group III, respectively. It was also observed that deep subfascial approach resulted in lesser postoperative swelling as compared to the other groups (mean score for Group I, Group II, and Group III, respectively, at seventh postoperative day was 27.2±1.13;22.1±0.86; and 20.14±2.09). At 6 months, all surgical sites in Group III had normal facial nerve function, whereas total palsy of temporal branch was seen in 1 case for Group I and mild dysfunction was noted in 1 case of Group II (Figure 1). ConclusionThe deep subfascial approach is the safest approach among the preauricular approaches to avoid injury of the facial nerve and yielded better postoperative result for pain and swelling. However, the traditional subfascial technique provided a quicker and blood-less field of dissection. Thus, either of the 2 approaches could be used depending on the surgeon's preference and training.

English

Superficial temporal space lies between the temporal fasciae. Abscess in the temporal and infratemporal space is very rare. They develop as a result of the extraction of infected maxillary molars. Temporal space infections or abscesses can be seen in the superficial or deep temporal regions. A 65 - year - old male patient reported with a complaint of painful swelling over the right cheek and restricted mouth opening with a history of extraction of second mandibular molar before four weeks. On examination, an ill-defined diffuse swelling was seen. Treatment was started with IV empirical antibiotics and planned for surgical drainage. Surgical drainage of the abscess in the temporal space was done along with debridement of the necrosed temporalis muscle. Infections of the maxillofacial region are of great significance to general dentists and maxillofacial surgeons. They are of clinical importance as they are commonly encountered, and are also challenging as timely intervention is needed to prevent fatal complications. The infections arising from the tooth are initially confined to the alveolar bone and surrounding periosteum. They spread along the path of the least resistance to the cortical plates. Once the infection penetrates the cortical plates, they reach the muscle plane.1 If the infection perforated is above the muscle attachments, it’s confined to an intraoral abscess. If the cortical plates are perforated below the muscular attachments, extraoral swelling develops. The next barrier is the periosteum which is strong and elastic in nature. Once the periosteum is breached, infections reach the soft tissue planes, the fascia. Most of the infections are confined to a particular space and the surrounding fascia. Based on the toxins produced by the microorganisms, the infection can spread to adjacent spaces and even retrograde. Common deep space infections are Ludwig's angina followed by peritonsillar, submandibular, and parotid abscesses. 2 Infratemporal and temporal space infections are rarely compared to other deep space infections. Many etiological factors form the base for the infections of deep spaces, dental caries, extraction of infected, non-infected tooth maxillary sinusitis, tonsillitis, maxillary sinus fracture, temporomandibular arthroscopy, drug-induced infections. Infections of odontogenic origin, spreading along infratemporal and temporal space are most common with maxillary molars followed by mandibular molars. We report a case of retrograde spread of buccal space infection into temporal space secondary to mandibular tooth extraction.

Success Rate of Type I Tympanoplasty Using Temporalis Fascia by Underlay Technique in Safe Mucosal COM in KMCH, Katihar.

Otitis media is inflammation of middle ear, commonly seen in children of school going age. Chronic otitis media is permanent abnormality of tympanic membrane most commonly as a result previous acute otitis media. Early diagnosis and management of chronic otitis media is important because it may affects hearing of child which in turn may affect cognitive development of children. This is a retrospective observational study done on 60 patients of age between 18 and 60 yrs during the period from May 2019 to November 2019 in ENT department of Katihar Medical College, Katihar, Bihar and assessed success rate of Type I Tympanoplasty using Temporalis Fascia by Underlay technique in safe mucosal COM. Success rate was 90% when preoperative dry ear was for more than one month. Graft taken up properly in 50 patients out of 60 cases i.e. 83.33%.

고식적 등골수술이 불가능한 등골고정 환자에서 등골절제 후 이소골성형술을 시행한 2예

Stapedial fixation result in conductive hearing loss, and the disrupted sound conduction mechanism could be restored with stapes surgery. Conventional stapes surgery cannot be performed in patients with disrupted ossicular chain, especially absence of incus and malleus. In this study, we reported two cases of stapedectomy with ossiculoplasty in patients with stapedial fixation and disrupted ossicular chain. Stapedectomy was performed in two patients and the oval window was covered with perichondrium or temporalis fascia. Total ossicular replacement prosthesis was inserted between tympanic membrane and oval window. All of patients showed improvement of hearing and subjective satisfaction for outcome. The postoperative air-bone gap was 8.3 and 26.7 dB. Postoperatively, no complication such as sensorineural hearing loss or dizziness was reported. Therefore, stapedectomy with ossiculoplasty is safe and effective treatment option for patients with conductive hearing loss due to stapedial fixation and disruption of ossicular chain. (J Clinical Otolaryngol 2021;32:143-148)

Endoscopic tympanoplasty using Tutoplast versus conventional microscopic tympanoplasty

BackgroundTemporalis fascia and perichondrium are still the most successful graft materials for primary microscopic repair of tympanic membrane perforations worldwide with 80% to 90% success rate. However, minimally invasive surgery is becoming standard in many fields and the endoscope has been largely incorporated in ear surgery over the past 10 years. This study aimed to evaluate the success rate of endoscopic transcanal closure of tympanic membrane perforation using Tutoplast® compared with the conventional post auricular approach using homologous temporalis fascia graft.ResultsOur study was conducted on 50 patients, were equally divided into 2 groups. Group A patients have been operated endoscopic transcanal using the Tutoplast as a graft material. Group B patients have been operated using a temporalis fascia graft through a post-auricular approach. The graft take rate, the pre- and post-operative pure tone audiogram, and operative time were compared in both the groups. The graft uptake rate was 100% in both groups. The mean of ABG showed significant improvement in both groups. In group A, the mean of ABG was 28.2 pre-operatively and became 12.12 post-operatively. In group B, the mean of ABG was 29.72 pre-operatively then became 15.2 post-operatively. Comparing the mean of post-operative ABG between both groups showed statistically significant difference as p value was 0.000496. We found a significant difference of the mean average operative time between both groups as the mean average time for group A was 48.08 min compared to 69.4 min for group B with p value 0.049772295.ConclusionsEndoscopic closure of tympanic membrane perforation using Tutoplast is successful short-time procedure avoiding the postauricular or endaural incisions with shorter operative time.

Destructive Frontonasal Mucocele Following Facial Trauma and Surgery

Mucoceles are fluid filled cysts with numerous etiologies that can erode bone and if left untreated, can lead to infraorbital and intracranial complications. With limited cases published in the medical literature, our patient with a frontonasal mucocele expanding from the frontal sinus to the nasal dorsum with erosion of the nasal bones and upper lateral cartilages, provides an opportunity for evidence-based diagnosis and treatment. We present a 24-year-old female with a nasal mass destroying numerous nasal structures. Three surgical approaches were considered: open rhinoplasty, bicoronal approach, and Lynch excision; the latter executed with subsequent total nasal reconstruction. Bone, septal cartilage, and temporalis fascia were utilized to provide structural support and a posterior nasal septal flap was incorporated to maintain a blood supply. integrity of nasal structure and cosmesis as well as recurrence of disease were monitored during postoperative visits.

Obliteration and Contouring of Comminuted Anterior Wall Frontal Sinus Fracture Using Pericranial Flaps.

Summary:One of the common postoperative complications of comminuted fractures of frontal sinus are contour deformity, hardware extrusion, adherence and/or palpability, and skin thinning. We are presenting our novel technique with pericranial flaps to decrease these complications. The study was performed from January 2019 to January 2020, on 40 cases of comminuted fractures of anterior wall of frontal sinus, 28 men and 12 women, with an average age of 41 years. Injury resulted from motor vehicle crashes (n = 25), motorcycle crashes (n = 11), and falling from heights (n = 4). Our novel technique involves the use of two anteriorly based pericranial flaps; one flap is used for obliteration of the frontal sinus and the other is used to overlay the hardware used to restore forehead contouring and to eliminate the possibility of early extrusion or late plates or mesh palpability. Two patients had postoperative minimal disruption of forehead lacerations healed with secondary intention and minimal scarring. Excellent patient compliance without any complaint of mesh palpability. No adherence occurred and no skin thinning. This technique (two anteriorly based pericranial flaps) may be more reliable to obliterate the frontal sinus also overlaying the hardware used to improve forehead contour and decrease the incidence of mesh palpability and skin adherence than using hardware without flap coverage.

Hearing Status After Cartilage Augmented Type III Tympanoplasty: In Chronic Otitis Media Squamous Type

Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoidectomy in patient with Chronic Otitis Media Squamous. The results from experimental and clinical studies of the type III stapes columellar reconstruction have shown that interposing a disk of cartilage between the graft and the stapes head improves hearing in the lower frequencies by 5 to 10 dB. They hypothesize that the cartilage acts to increase the “effective” area of the graft that is coupled to the stapes, which leads to an increase in the middle ear gain of the reconstructed ear. Aims: To assess the hearing improvement after cartilage augmented Type III Tympanoplasty in chronic otitis media squamous disease. Methods: This study was conducted in 44 patients with Chronic Otitis Media squamous in the patients attending the department of Otorhinolaryngology in NGMC teaching hospital from November 2018 to March 2020. Canal Wall Down mastoidectomy with cartilage augmented type III Tympanoplasty and was done. Augmentation was done with thin 3-4 mm conchal cartilage interposed between stapes and Temporalis fascia graft. Results: There were 11(25%) male and 33(75%) female, with mean age of 29.48 years, ranging from minimum of 15 years to maximum 56 years. The preoperative mean A–B gap was 21.82 and postoperatively means AB gap was 12.20 dB with overall AB gap gain was 9.64 dB. Conclusion: Significant hearing improvement is seen in Canal Wall Down mastoidectomy Chronic Otitis Media squamous after cartilage augmented type III tympanoplasty.

The Effect of Anteriorly Located Sigmoid Sinus on Postoperative Hearing Gains: A Case-Control Study.

There are many studies on the effects of temporal bone anatomical variations on a mastoid pneumatization. Considering the effects of the anatomic variations on mastoid pneumatization, it is considered that many anatomic variations may affect graft success rates and postoperative hearing threshold gains. We aimed to evaluate the effects of various anatomic variations on postoperative hearing gains among patients undergoing tympanoplasty. This retrospective cohort study conducted in a tertiary-care university hospital. This study enrolled 57 patients who underwent primary type 1 tympanoplasty operation using the temporal muscle fascia. The patients were divided into two groups as those with an anteriorly located sigmoid sinus (group 1), and no anatomic variation (group 2). Airway gain values at the frequency range of 250Hz-8000Hz and pure tone average (PTA) value were calculated preoperatively and at postoperative sixth month. The gains attained by the patient groups with anatomic variations were compared with group 2. There were significant differences between Group 1 and Group 2 in terms of the airway frequencies of 250, 500, 2000, 4000Hz, and PTA value. We detected a lesser postoperative hearing gain in patients with an anteriorly located SS. We believe that anatomic variations that may affect middle ear and mastoid cavity may also affect postoperative hearing gain.

Infection rate following elective oculoplastic surgery in a minor procedure setting: a single-centre retrospective study

ObjectiveA surgical site infection after oculoplastic surgery is a serious complication that can lead to endophthalmitis and vision loss. Although performing these procedures in a minor-surgery setting is common, there is a lack of evidence in the literature regarding the incidence of postoperative infections. The objective of this study was to determine the infection rate associated with elective outpatient oculoplastic procedures performed in a minor-surgery setting. MethodsA retrospective review was completed for all patients who underwent elective oculoplastic surgery in the minor-procedure room at the Misericordia Health Centre in Winnipeg between April and December 2018. Operations were performed by 2 senior oculoplastic surgeons. Data collected included the type of procedure, number of surgical incisions, type and number of sutures, use of prophylactic antibiotics, time to follow-up, complications, and presence of surgical site infection. ResultsReview of 539 patients showed an infection rate of 0.37% (2 of 539). Infection cases were an exposed orbital implant using a temporalis fascia graft and ptosis repair using a frontalis sling. Thirteen complications were identified, corresponding to a complication rate of 2.41% (13 of 539). ConclusionStudy results show an infection rate of 0.37% for elective oculoplastic surgery in a minor-procedure setting.

A Comparative Study Between the use of Temporalis Fascia and Fascia Lata as Graft During Tympanoplasty Performed in A Tertiary Care Centre

Background: Chronic suppurative otitis media is a common otological condition in India causing hearing loss for which patients seek advice from an otolaryngologist. The perforation seen in chronic suppurative otitis media may be the only sequel remaining when the pathological process in middle ear cleft has healed. Tympanoplasty, the procedure for repairing the perforations of the pars tensa, can be done using a variety of graft materials. In this study two different types of graft materials, fascia lata and temporalis fascia, which can be used in tympanoplasty will be studied. The study will help to know which is better in terms of graft uptake as well as improvement in hearing. This will help in a better understanding of which grafts can be used in tympanoplasty in the future. Aims and Objectives: To compare hearing gain and graft uptake rate between temporalis fascia and fascia lata in tympanoplasty and to study the postoperative morbidity/complications associated with the 2 modalities. Materials and Methodology: The study was conducted on 42 patients divided in 2 groups of 21 each. The 1st group underwent tympanoplasty type 1 by endomeatal approach using fascia lata graft and the 2nd group by a post aural approach using temporalis fascia graft. Regular follow ups and otoscopic examination was done on the patients to check the graft uptake. Pure tone audiometry was done after a minimum period of 2 months post-surgery and was compared with the preoperative audiometry to assess the hearing improvement in hearing. Results and Conclusions: This study compared both temporalis fascia and fascia lata as graft materials used in tympanoplasty. Graft uptake results and gain in hearing were better with temporalis fascia as compared to fascia lata. Temporalis fascia was also associated with lesser post-operative complications. So this study finds that tympanoplasty done by postaural technique using temporalis fascia is better in terms of graft uptake, hearing improvement and postoperative complications when compared to tympanoplasty done by fascia lata.