A Novel Technique to Salvage Failing Tympanoplasty- A Prospective Interventional Trial

Abstract

BACKGROUND This article describes a procedure to salvage graft failures in cases of Tympanoplasty done using Temporalis Fascia by early intervention, Post operatively. METHODS It was an Observational study using 30 patients with residual perforations on 3 rd-6 th post-operative week out of 131 patients who underwent Type 1 Tympanoplasty with Cortical Mastoidectomy using Temporalis fascia as graft material. Study was conducted over a period of 18 months. Patients having residual perforation underwent the procedure after proper informed consent. 4 Quadrant blocks were given in External Auditory canal. The Epithelialized margin was freshened using a Micropick and medialised graft was repositioned after placing of a piece of Gelfoam in middle ear. The perforation was reinforced with a Gelfoam laterally in External Auditory Canal. Patient was then followed up with a course of Antibiotic and antihistaminic. RESULTS Out of 131 patients of cortical mastoidectomy with tympanoplasty 30 had residual perforation on follow up i.e., 77% success rate while 23% failure rate in our hand. These 23% patients, who were found to be failing, underwent this intervention. 24 out of these 30 patients (80%) i.e., 18% of overall cases showed healed drum after intervention on further follow up. Thus, a good number of failing Tympanoplasty could be salvaged and overall success achieved is almost 95% as compared to 77% previously.