Terms Of Graft Uptake Research Articles

Use of Collagen Sheets as Graft Material for Myringoplasty.

The purpose of the study is to investigate how Collagen sheet used as graft material in Myringoplasty improves hearing and tympanic membrane tissue repair in patients with tympanic membrane perforation (TMP) in an office based procedure. Total 50 cases included in the study where Collagen sheet used as graft material for myringoplasty in small to moderate size tympanic membrane perforations(TMP) and procedure performed in an office based set up with the help of a High definition endoscope and camera. Cases followed up regularly and results observed in terms of graft uptake and complete closure of TMP and hearing improvement. Out of 50, complete closure of TMP observed in 39 cases and an average hearing gain of 9.9 db noted in these cases. Success rate of 78% achieved and failed cases were subjected to traditional post auricular method of myringoplasty under microscopic guidance. Myringoplasty with the help of collagen sheet material in an office based set up is an easy, minimally invasive and effective technique and it avoids need for major invasive intervention in a significant number of patients.

Effect of type 1 tympanoplasty on the quality of life of patients suffering from chronic otitis media (safe type).

Chronic otitis media (COM) remains a major public health issue and is associated with relentless discharge from the ear, pain, significant functional limitation of hearing, leading to communication problems and frequent specialist visits. To assess the improvement in quality of life of patients of COM (safe type) and surgical success in terms of graft uptake and improvement in hearing. A prospective questionnaire-based outcome study was directed in 100 patients with COM who were treated with Type I Tympanoplasty at our institution between May 2018 and May 2020. All patients were asked to fill Modified Chronic Otitis Media 4 (COM-4) survey before operation and 3 months after operation. Preoperative and postoperative total ear scores, audiological results, postoperative graft uptake were assessed. The correlation between preoperative and postoperative assessment by questionnaire was statistically critical (P < 0.001). There was significant improvement in hearing postoperatively (P < 0.001). Effective graft uptake was seen in 80%. The current study emphasizes that Type 1 Tympanoplasty fundamentally improves quality of life of patients in terms of physical suffering, hearing loss, emotional distress postoperatively.

Comparative study of outcomes of type 1 tympanoplasty with and without anterior tucking

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Type-1 tympanoplasty is the functional restoration of the normal middle ear by repairing the tympanic membrane (TM). Different techniques are still evolving to devise a way to give optimal graft uptake and hearing improvement with minimal instrumentation. Various studies have been done to assess the role of anterior tucking in type-1 tympanoplasty and to assess its superiority over other methods in repairing subtotal perforations and large perforations involving the anterior quadrant.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was done to compare the outcomes of endoscopic type-1 tympanoplasty with and without anterior tucking. 60 cases of chronic otitis media (COM) mucosal type were divided into 2 groups of 30 patients each. Group 1 underwent endoscopic type-1 tympanoplasty with anterior tucking and group 2 underwent endoscopic type-1 tympanoplasty without anterior tucking. The outcomes were evaluated after 6 months and compared in terms of graft uptake and hearing gain.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean air-bone gap improvement was 13.16±2.65 in group 1 and 12.90±3.78 in group 2, which had statistically insignificant differences indicating similar hearing outcomes in both the groups. 96.7% successful graft uptake was achieved in group 1 and 90% in group 2, showing statistically insignificant differences indicating similar graft uptake rates in both the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Anterior tucking with endoscopic type-1 tympanoplasty could provide good graft support and efficient hearing improvement but cannot be labelled as a mandatory step in repairing subtotal perforations or large perforations involving anterior quadrant as the outcomes are comparable to the endoscopic type-1 tympanoplasty done without anterior tucking. &lt;/p&gt;

A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media is a highly prevalent disease of middle ear. As tympanoplasty plays an important role in management of otitis media it is important to predict the outcome of surgery and give proper counselling to the patient. The objective of this study was to evaluate the effectiveness of Middle ear risk index (MERI) in determining postoperative graft uptake and postoperative air bone gap closure following tympanoplasty.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was a retrospective study conducted to find the correlation between MERI and the result of tympanoplasty outcome and post-operative hearing gain. Ninety-six subjects who underwent tympanoplasty for chronic otitis media were included in the study. MERI score was calculated and was compared with postoperative graft uptake and audiogram. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In this study there was no statistical difference in graft uptake between the MERI categories. There was statistically significant decrease in postoperative air bone gap closure in both mild and moderate categories. Other prognostic factors associated with a favourable outcome were healthy middle ear mucosa and absence of smoking.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; MERI did not have a direct impact on the outcome of surgery in terms of graft uptake and hearing results. However certain factors like Belluci’s criteria and smoking had an impact on the outcome. Hence MERI can be used for pre-operative counselling of the patients.&lt;/p&gt;

Our Experience of Tie Over bolster and Quilting Sutures Versus Stapler fixation for Split thickness skin graft in post burn neck contracture – A Comparative study

Background: Traditional method to fix Split thickness skin graft in post burn neck contracture is Tie over Bolster dressing and Quilting sutures. We used staplers to fix split thickness skin graft. Materials &amp; methods: A comparative study conducted in 30 patients with post burn neck contracture at Dr. Vasantrao Pawar Medical College, Nashik, during January 2015 to December 2020. Time required for fixation of split thickness skin graft, outcome in terms of graft uptake and patients comfort level while removing sutures and stapler recorded. Results: Total 30 Patients were included in our study. Mean time required for Tie over and quilting suture was 10.53 ± 0.88 min, significantly higher than the mean time in stapler fixation 4.87 ± 0.81 min. (p&lt;0.001). Graft take was 95% in stapler and 93% in Tie over and quilting suture. Conclusion: Fixation of Split thickness skin graft with stapler is more rapid, less time consuming also results in decreased surgical and anaesthesia time. More patient friendly while removing staplers with comparable skin graft uptake.

TO ASSESS THE OUTCOME OF ENDOSCOPIC INTERLAY TYMPANOPLASTY IN TERTIARY CARE CENTER

Background: Chronic otitis media is an inammatory process in middle ear cleft which is treated by a common otological procedure tympanoplasty to reconstruct the tympanic membrane and to restore sound-conducting mechanism. Rigid endoscope in transcanal interlay tympanoplasty has signicant advantage as it provides magnied, and wide angle view, with better success rate and postoperative hearing gain. The Aims and objectives were to assess the outcome of endoscopic interlay tympanoplasty, in terms of graft uptake, hearing improvement and rate of complications in cases of inactive mucosal chronic suppurative otitis media. Methods: This prospective study was conducted for 1 year at our institution in 50 patients having conductive hearing loss with dry, central perforation. All patients underwent transcanal endoscopic interlay tympanoplasty and were followed up for 3months to determine the graft uptake, hearing improvement and rate of complications. Results: Graft uptake rate in the present study was found to be 98% with residual perforation as a complication in 2% patients and no other complications were encountered. Post operatively air bone gap (ABG) after 12 weeks found to be &lt; 20 dB ABG in 84% patients. Conclusion: Endoscopic interlay tympanoplasty is a effective method with high success rate both in terms of graft uptake as well as post operative hearing improvement and can be implemented in all cases of inactive mucosal COM.

Vertical Strut Ossiculoplasty: A Versatile Alternate to Conventional Techniques-A Randomized study.

Various ossicular reconstruction materials and techniques have been described in literature using autologous ossicle, cortical bone, autologous cartilage, synthetic materials and implants like total/partial ossicular replacement prosthesis (TORP/PORP) etc., but it has always been a topic of controversy in terms of the efficacy, longevity and complications of the material or method used. This is a prospective, interventional, comparative, double-blind randomized control study which was done at a tertiary care center to compare outcomes of conventional and carved conchal cartilage (vertical strut) type III Tympanoplasty in terms of graft uptake and hearing gain. A total number of 52 cases were enrolled, randomized and allocated to 2 groups (26 each) i.e. group A (conventional type III) and group B (vertical strut technique). Graft uptake was seen in 25 (96.16%) patients in group B while it was observed in 23 (88.5%) cases in group A. Hearing gains were also better in group B. This study suggests that Vertical Strut technique can be studied further as it gives better gains in Air Conduction threshold and A-B Gap along with graft uptake as it provides better middle ear space and ossicular / tympanic membrane interface resulting in better hearing.

Correlation of Status of Mastoid with Outcomes of Myringoplasty with Cortical Mastoidectomy in Mucosal Otitis Media with High Risk Perforation

Introduction Chronic mucosal otitis media is one of the common disease prevalent in our society. This study was done to correlate the status of mastoid with outcomes of myringoplasty with cortical mastoidectomy in mucosal otitis media with high risk perforation.&#x0D; MethodsThis prospective, observational study was done at Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University Teaching Hospital. Thirty-four patients of ag|e 15 and above with chronic mucosal otitis media having high-risk perforation undergoing cortical mastoidectomy with myringoplasty were included. The status of middle ear, aditus, and mastoid air cells were assessed. Post-operatively, patients were assessed for graft uptake and hearing after three months. The post-operative graft uptake and hearing results were correlated with the peroperative status. Four patients who had preoperative sensorineural hearing loss were studied in terms of graft uptake only.&#x0D; ResultsThe graft success rate in patients with normal mastoid air cells was 90% whereas in diseased cases was 71.4% which was statistically not significant with p value 0.20. The success rate in terms of hearing was 68.8% in normal mastoid whereas it was 64.3% in diseased mastoid which was statistically not significant with p-value of 1.&#x0D; ConclusionIn correlation with the status of mastoid air cells with graft uptake and hearing result, the observed differences were not statistically significant. However, averages of post-operative air conduction threshold and air-bone gap of all cases were better as compared to preoperative levels.

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.&#x0D; 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.&#x0D; 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.&#x0D; 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.&#x0D; 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.&#x0D; Bangladesh J Otorhinolaryngol; April 2021; 27(1): 86-91

Evaluation of the role of middle ear risk index as a prognostic tool in cases of tympanoplasty in chronic suppurative otitis media

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; In chronic suppurative otitis media (CSOM), the success rate of tympanoplasty, can range from 35% to 92% and is influenced by a number of factors such as age of patient, size and site of perforation, status of ear, ossicular status and surgical technique. The middle ear risk index (MERI) of a CSOM patient is an effective numerical grading system helpful in predicting the outcome of surgery. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective observational study was conducted in 50 patients over a period of 1 year including all cases of CSOM in age group of 18-55 years with conductive hearing loss that underwent tympanoplasty with or without cortical mastoidectomy and role of MERI was analysed for the outcome of the surgery. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Successful graft uptake was seen in 92% cases while in 8% cases graft was rejected. Of these 46 cases, 32 cases had mild MERI score, 10 had moderate MERI score and 4 had severe MERI score. It was observed that higher the MERI score, lower the graft uptake. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Our study comprised of 50 patients of CSOM which were categorized into mild, moderate and severe on the basis of MERI score preoperatively. All the patients underwent tympanoplasty with or without cortical mastoidectomy and surgical outcome in terms of graft uptake was found to be significant. Higher the MERI score, lower was the graft uptake while lower the MERI score, higher was the graft uptake. Hence, MERI is a useful tool to ascertain the prognosis of tympanoplasty.&lt;/p&gt;

Over-Underlay technique of myringoplasty.

Objective: To observe the success rate of Over-underlay technique of myringoplasty in patients with inactive tubo-tympanic type of CSOM. Study Design: Descriptive, Observational study. Setting: ENT Department Fauji Foundation Hospital Rawalpindi. Period: December 2018 to December 2019. Material &amp; Methods: A total of 80 patients with inactive tubo-tympanic type of CSOM, from both genders, within age range of 15-45 years, having pure conductive hearing loss with an Air-Bone gap of not less than 15 dB were selected by convenient sampling technique. Patients having an active ear disease or previous history of ear surgery, an active sinus or URT disease, or any comorbidity were excluded from the study. Complete general and head-neck examination was done after taking history. Patients’ affected ears were examined under surgical microscope to see the drum perforation, condition of middle ear mucosa and the status of the ossicles. Hearing assessment was done by Pure Tone Audiometry through both air and bone conduction. Temporalis fascia graft myringoplasty was done in all these patients by over-underlay technique, and they were discharged on 5th post-operative day, and were followed up in ENT OPD after 3 weeks. Status of graft was seen under surgical microscope after removing the BIPP. After three months the patients were reviewed for graft status and hearing assessment. Successful outcome was taken as those patients in whom graft uptake was successful with complete closure of perforation, and secondly, closure of the Air-Bone gap by at least 10 dB. Data was analyzed by SPSS 19. Results: Mean age of the patients (n = 80) was found to be 30.8 Years. Gender distribution showed 57 (71.25%) Males and 23 (28.75%) Females with a M:F ratio of 2.5:1. Success rate was found significantly better among younger aged males. Graft uptake was successful in 74 (92.5%) of the patients. With respect to closure of A-B gap, post-operative mean difference in Air-Bone gap was found to be 9.6 dB ± 3.9 SD as compared to preoperative mean A-B gap of 28.5 dB ± 4.2 SD, thus a closure of A-B gap by 18.9 dB ± 2.4 SD. Conclusion: Over-underlay technique is found to be a successful technique for myringoplasty in terms of graft uptake and improvement in hearing thresholds in the patients with inactive tubo-tympanic type of CSOM.

Endoscopic ear surgery in middle ear cholesteatoma

ObjectiveEndoscope has been used as diagnostic tool for recidivism and as an adjunct to microscopic technique in the management of cholesteatoma. At present transcanal endoscopic ear surgery (TEES) is being used as a minimally invasive alternative for microscopic approach. We aim to evaluate the feasibility, structural, functional and quality of life outcomes of endoscopic technique in middle ear cholesteatoma. MethodThis prospective study was conducted at a tertiary care hospital from January 2017 to January 2018 including 32 adult patients who were treated by TEES for middle ear cholesteatoma. Feasibility of endoscopic technique was assessed by the conversion rates, visualization of middle ear structures and complications. Structural outcomes were evaluated in terms of graft uptake at the third month follow-up and presence of residual or recurrent disease. Functional outcomes were evaluated in terms of post-operative air-bone gap closure at third month follow-up. Patient outcomes in terms of post-operative pain, cosmetic score, day of return to daily activities and patient comfort scores were evaluated. The quality of life outcomes were evaluated using chronic ear survey (CES) and short form questionnaire −12 version 2 (SF-12V2) which are disease specific and general quality of life assessment tools respectively. ResultOut of 32 patients, endoscopic intact canal wall mastoidectomy was done for 28 and endoscopic canal wall down mastoidectomy in 4 patients. One (3.1%) patient had to be converted to microscopic technique. Median follow-up period was 32.8 months (9–46 months). There were no post-operative complications in any of our patients. The mean middle ear structural visibility index score was 8.4 ± 1.4 with the use of zero-degree endoscope. Graft uptake rate at third month follow-up was 100%. Two (6.3%) patients had recurrent disease at 6 months follow-up and were treated by revision endoscopic surgery. The air conduction (51.3 ± 20.2 dB vs. 34.5 ± 20.4 dB, p < 0.001), and air-bone gap (33.5 ± 11.1 dB vs. 16.9 ± 11.8 dB, p < 0.001) has been significantly improved. The mean pain score at 0 hours, 6 hours and 24 hours after surgery were 2.5/10, 1.6/10 and 0.75/10 respectively. At the discharge, the mean patient comfort score was 9.3 ± 0.6 out of 10. Mean cosmetic score was 9.3 ± 0.5 at the third month follow-up. There was significant post-operative improvement in the sub-scale and total scores of CES and SF-12V2. ConclusionEndoscopic approach to middle ear cholesteatoma is feasible and confers excellent structural, functional as well as patient related quality of life outcomes.

Endoscopic management of stage-2 attic cholesteatoma: An institutional study

Aim: All cholesteatoma cases are managed surgically under microscopic visualization since decades. But, the recurrence of the disease was found due to inadequate removal of cholesteatoma tissue from the hidden areas such as anterior attic region, tubotympanic recess, sinus tympani, and facial recess. Objectives: An angled otoendo scopes with panoramic view increases the accessibility and thereby thorough clearance of cholesteatoma which leads to better outcome. Materials and Methods: This prospective observational study evaluates the long-term results of transcanal endoscopic management of Stage-2 attic cholesteatoma. It was conducted at the Department of Otorhinolaryngology, from January 2018 to January 2020. Eighteen patients with acquired limited attic cholesteatoma had undergone endoscopic transcanal tympanotomy and atticotomy for the complete removal of cholesteatoma sac. Reconstruction of attic with a composite tragal cartilage was performed in all cases. Results: Office-based endoscopic inspection of ear in all cases was done up to 6 months in terms of graft uptake and recurrence. Postoperative hearing evaluation at 3 months and 6 months was also performed. All cases in our series had good graft uptake with improved hearing. There was no recurrence and one case had postoperative granulation which was managed with culture and sensitivity directed antibiotics and regular aural toileting. Conclusion: Thus, an endoscopic transcanal surgical management of attic cholesteatoma is a less invasive procedure with long-term results that compare well to those of postauricular microscopic approach.

Comparison of Endoscopic Tympanoplasty with Microscopic Tympanoplasty

Background:&#x0D; Minimally invasive surgery has recently been developed along with endoscopic techniques. Endoscopic Ear Surgery is becoming popular with its anatomic and physiologic concepts. Tympanoplasty is one of the commonest operations performed for the middle ear. While using the endoscope we can place the graft accurately while avoiding unnecessary post or endaural incision and soft tissue dissections which are mandatory during tympanoplasty using a microscope. Our study was aimed to compare the outcomes of endoscopic and microscopic tympanoplasty in terms of graft uptake, hearing outcome and postoperative pain.&#x0D; Methods:&#x0D; This is a retrospective comparative study of 63 patients who underwent type 1 tympanoplasty at Holy Family Hospital ENT Department from March 2017 to March 2020. The subjects were classified into 2 groups; Endoscopic tympanoplasty (ET, n=30), Microscopic Tympanoplasty (MT, n=33). Type 1 Tympanoplasty, was the procedure done on patients of both the groups.&#x0D; Demographic data, perforation size of the tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3 months postoperatively, operation time, sequential postoperative pain scale (NRS-11), and graft success rate were evaluated.&#x0D; Results :&#x0D; The perforation size of the tympanic membrane in the Endoscopic group and the microscopic group was nearly the same (p=.877). Pre and post-operative air-bone gaps including air and bone conduction thresholds were not significantly different between the two groups. The graft success rate in the endoscopic and Microscopic group was 93.3% and 63.3% respectively; the values were significantly different(p=0.0046). Immediate and 6 hours postoperative pain was similar in both the groups, however pain on ist postoperative day was significantly lower in the endoscopic group.&#x0D; Conclusion:&#x0D; We can do minimal invasive tympanoplasty with the help of endoscopes with better graft success rate, less preoperative time, and less postoperative pain.

Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p&amp;lt;0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.&lt;/p&gt;

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.

Comparative Study of Outcome of Type 1 Tympanoplasty in Dry and Wet Ear in Tertiary Care Hospital.

Chronic suppurative otitis media is very common otological disease in general population. Persistent wet ear produces dilemma for ENT surgeons whether to go ahead with tympanoplasty or not. Present study compare outcome of type 1 tympanoplasty in both wet and dry ear. Present study is randomized, prospective, Interventional type of study carried in ENT department of tertiary care hospital over period of 18months. Total 62 cases fulfilling study criteria were included in the study, which were equally divided in dry and wet group. All cases underwent type 1 tympanoplasty. Temporalis fascia was used as graft material in all cases. Most of the patients in both dry and wet group belonged to the age group between 21 to 30 (40.32%). 26 (41.94%) were males and 36 (58.06%) were females. Male: Female ratio was 1:1.38. After 12weeks 27 (87.10%) cases of dry group and 20 (64.52%) cases of wet group had significant hearing improvement and in dry group 28 (90.32%) cases had intact graft while in wet group 23 (74.19%) cases had intact graft. According to the statistical analysis, in current study, there is no significant differences between the success rates of wet and dry ears, either in terms of graft uptake or the hearing improvement, thus it can be concluded that the presence of minimal ear discharge at the time of surgery does not affect the success rate of type 1 tympanoplasty.

Endoscopic interlay tympanoplasty: our experience

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media is treated conventionally by tympanoplasty using a temporalis fascia graft using a microscope, through a post aural approach. The present study comprises of 50 cases of chronic otitis media, which were treated by endoscopic interlay technique of tympanoplasty, combining two novel approaches in otological surgery.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Total of 50 patients were studied, with in a period of one year at our institution. All of them underwent type I endoscopic tympanoplasty by interlay method. All of whom were followed up for 6 months. Patients were evaluated in terms of graft uptake, improvement in hearing and rate of complications. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In the present study, we have recorded a graft uptake rate of 98%. The mean post operative air bone gap at the end of 6 months was 0.9 dB (p=0.001) which was statistically highly significant.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Endoscopic interlay tympanoplasty is a novel and preferred technique, which could be implemented in all cases of dry chronic otitis media.&lt;/p&gt;

Endoscopic Transcanal Myringoplasty-Smart Myringoplasty for Nex Gen ENT Surgeons: Our Experience.

Otolaryngology is one of the branch where endoscopes is being widely used nowadays to perform different surgeries. Ear surgeries are of special interest among the ENT surgeons. It has several advantages compared to the microscopes. 60 patients underwent endoscopic transcanal myringoplasty by the postgraduate residents under direct supervision of same consultants, using temporalis facia graft. The overall success rate in terms of graft uptake was 86.67% and the AB gap closure of < 10 dB in 63.3% of cases and 10-20 dB in 33.3%. Endoscopic myringoplasty was found to be equally effective, less morbid and very cost effective than the microscopic myringoplasty. This was applicable irrespective of the size of the perforation and condition of the middle ear (dry/wet) in our centre.

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 &amp; 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.