Comparative Study of Underlay Tympanoplasty with Temporalis Fascia and Tragal Perichondrium

Kumar, Rakesh; Suman, Rajesh Kumar; Garje, Yogesh A.; Rao, Suman

doi:10.9790/0853-13538998

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…41 % closure of AB gap at 8 weeks post operatively. The study by Harkare et al20 , Rakesh Kumar et al21 , Patil et al22 and Shyamakant Prasad et al23 showed 56%, 45%, 47% and 49% closure of AB gap respectively at 12 weeks post operatively.In Group B, a 45.66 % closure of AB gap was observed in 8 weeks post-operative. The study by Harkare et al20 showed 46% closure of AB gap, Rakesh Kumar et al21 showed 40% closure of AB gap, Patil et al22 showed 50% closure of AB gap and Shyamakant Prasad et al23 showed 52% closure of AB gap at 12 weeks post operatively.…”

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confidence: 94%

“…The study by Harkare et al20 , Rakesh Kumar et al21 , Patil et al22 and Shyamakant Prasad et al23 showed 56%, 45%, 47% and 49% closure of AB gap respectively at 12 weeks post operatively.In Group B, a 45.66 % closure of AB gap was observed in 8 weeks post-operative. The study by Harkare et al20 showed 46% closure of AB gap, Rakesh Kumar et al21 showed 40% closure of AB gap, Patil et al22 showed 50% closure of AB gap and Shyamakant Prasad et al23 showed 52% closure of AB gap at 12 weeks post operatively. Similarly, Güneri et al, Ozbek et al and Wielgosz et al have also claimed a better graft uptake rate and hearing outcome in cartilage tympanoplasty compared with temporalis fascia in type-I tympanoplasty 24.…”

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confidence: 94%

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Comparative Study of Temporalis Fascia Graft versus Cartilage Shield Tympanoplasty in Chronic Otitis Media - Mucosal Type

Shrestha

Paduel

Bhandari

et al. 2022

J. Nepalgunj Med. College

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Introduction: Tympanoplasty is the procedure of choice for surgical correction of tympanic membrane perforation triggered by either chronic otitis media or trauma. Various types of autologous grafts have been used to close tympanic membrane perforations among which temporalis fascia and tragal cartilage are preferred, due to their anatomic proximity, ease of harvesting and suppleness. Aims: To compare clinical and audiological outcomes of type 1 tympanoplasty where temporalis fascia and tragal cartilage were used as the graft material. Methods: A prospective study was conducted on 50 patients of ages ranging from 10 to 50 years with Chronic Otitis Media - Mucosal. All the patients underwent type 1 tympanoplasty and were categorized into Group-A (Temporalis fascia graft) and Group-B (Cartilage graft), each group comprising of 25 patients. Graft uptake rate, hearing gain and air bone gap closure were compared between the groups in 4 and 8 weeks after surgery. Results: Out of total 50 patients, 20 were male and 30 were female. The average age of the patients was 28.20 years. The total hearing gain in the whole series was 14.94 dB while the total air bone gap closure was 14.78 dB respectively. The difference between pre and post-operative hearing was statistically significant for both air bone gap and air conduction, (P<0.05) in the whole series. There was 15.56 dB improvement in mean hearing threshold and 15.64 dB mean air bone gap closure in the fascia group, compared to 14.32 dB improvement in mean hearing and 13.92 dB mean air bone gap closure in the cartilage group. Graft uptake rate in the temporalis fascia group was 84% and the cartilage group was 92 % with significant difference in the graft uptake rate between the groups. Conclusion: The graft uptake rate and hearing results of tragal cartilage are comparable to those of temporalis fascia. Cartilage tympanoplasty has a higher graft uptake rate with low failure rate and also shows a high degree of reliability in high risk cases. Both cartilage and fascia tympanoplasty provided similar improvements in the hearing outcome post-operatively. Thus, cartilage tympanoplasty is recommended as an alternative option.

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confidence: 94%

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confidence: 94%

Comparative Study of Temporalis Fascia Graft versus Cartilage Shield Tympanoplasty in Chronic Otitis Media - Mucosal Type

Shrestha

Paduel

Bhandari

et al. 2022

J. Nepalgunj Med. College

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“…The postoperative results of fascia graft is unpredictable due to its irregularly arranged elastic and fibrous tissues, in literature varius techniques of cartilage tympanoplasty have been described, like palisade technique, perichondrium cartilage island, cartilage shield technique and inlay butterfly graft technique. 6,7 The reported success rate of cartilage tympanoplasty in literature is more than 98%, The use of cartilage and perichondrium as graft material was popularized by Goodhill with observed low rejection rate, sufficient and easy availability, best tensile strength, possessing conductive qualities similar to tympanic membrane. 6,7 Moreover cartilage metabolism is slow and it receives nutrition by diffusion, cartilage remains stable in poor condition like negative pressure and eustachian tube dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 The reported success rate of cartilage tympanoplasty in literature is more than 98%, The use of cartilage and perichondrium as graft material was popularized by Goodhill with observed low rejection rate, sufficient and easy availability, best tensile strength, possessing conductive qualities similar to tympanic membrane. 6,7 Moreover cartilage metabolism is slow and it receives nutrition by diffusion, cartilage remains stable in poor condition like negative pressure and eustachian tube dysfunction. 8 Disadvantages cartilage graft are that hearing outcome is less as compare to temporalis fascia ant it can hide underlying residual cholesteatoma.…”

Section: Introductionmentioning

confidence: 99%

Study on outcome of tympanopanoplasty: a two year institutional study

Pathak

Saxena

Nayak

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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Background: Tympanoplasty is one of the common surgical procedure performed in CSOM (TTD), this study was undertaken to determine the outcome of tympanoplasty at a tertiary care teaching hospital.Methods: This analytical observational study was conducted in the department of E.N.T, School of Medical Sciences and Research, from January 2017 to December 2018. Informed consent was taken to participate in the study pure tone audiometry (PTA) was performed before surgery and post-operatively six months. Air-bone gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). The p value ≤0.05 was considered statistically significant. Results: Over a peroid of 2 years 168 patients underwent type 1 tympanoplasty 86 were male 21 (51.19%), female 82 (48.80%), age (range 15–53 years). Mean pre-operative air-conduction of 43.12 dB was significantly reduced to 16.12 dB with p value of <0.05. Similarly the pre-operative mean air bone gap on PTA of 35.63±6.35 dB was also reduced to statistically significant level of 7.41±3.51 dB on post-operative PTA with p value of <0.05. Graft was taken up well in 152 cases (90.2%).Conclusions: According to our study surgical outcome of tympanoplasty is fairly good and should be done if patient gives consent.

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“…The success rate of cartilage tympanoplasty is more than 98% 6. The concept of cartilage and perichondrium was introduced by Goodhill on the basis of its advantages of low rejection rate, sufficient and easy availability, best tensile strength, possessing conductive qualities similar to TM 7. Moreover cartilage metabolism is slow and its nutrition is via diffusion, stable in poor condition like negative pressure and eustachian tube dysfunction etc 8.…”

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confidence: 99%

Tympanoplasty Type-I using tragal perichondrium graft: Our experience

Wahid

Nagra

2019

Pak J Med Sci

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Objective: To determine the efficacy of tragal perichondrium graft used in tympanoplasty Type-I at a tertiary care hospital. Methods: This descriptive case-series study was performed at the department of E.N.T, Head and Neck Surgery, Medical Teaching Institution/Lady Reading Hospital (MTI/LRH), Peshawar, Pakistan from June 2017 to May 2018. After approved from IREB, a well informed consent was taken. Pure Tone Audiometry (PTA) was performed before surgery and post-operatively at three and six months interval. The mean ± SD Air-Bone Gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). Chi-square (X2) test of significance was used taking confidence interval at 95%. The p-value ≤0.05 was considered significant. Results: Total patients were 36; male 21 (58.3%), female 15(41.7%) with male: female ratio of 1.4:1. Mean ± SD age was 27.14 ± 7.49 years (Range 15 – 50Years). Tympanic membrane perforation was commonly found on right side 22 (61.1%), predominantly involving anterioinferior site 19 (52.8%) and medium sized perforation outnumbered 22 (61.1%). Mean pre-operative air-conduction of 49.72 dB was significantly reduced to 18.27 dB with pvalue of <0.05. Similarly the pre-operative mean air bone gap on PTA of 45.63 ± 8.35dB was also reduced to statistically significant level of 7.41 ± 3.51 dB on post-operative PTA with p-value of <.05. Graft was taken up well in 34 cases (94.4%). Conclusion: Tragal perichondrial graft is an effective grafting material used for tympanoplasty due to its possessing qualities. doi: https://doi.org/10.12669/pjms.35.4.421 How to cite this:Wahid FI, Nagra SR. Tympanoplasty type I using tragal perichondrium graft: Our experience. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.421 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comparative Study of Underlay Tympanoplasty with Temporalis Fascia and Tragal Perichondrium

Cited by 6 publications

References 6 publications

Comparative Study of Temporalis Fascia Graft versus Cartilage Shield Tympanoplasty in Chronic Otitis Media - Mucosal Type

Comparative Study of Temporalis Fascia Graft versus Cartilage Shield Tympanoplasty in Chronic Otitis Media - Mucosal Type

Study on outcome of tympanopanoplasty: a two year institutional study

Tympanoplasty Type-I using tragal perichondrium graft: Our experience

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