Comparison of results of graft uptake using tragal cartilage perichondrium composite graft versus temporalis fascia in patients undergoing surgery for chronic otitis media – squamous type

Abstract

BackgroundTo assess, analyze and compare the results of graft uptake using Tragal Cartilage-Perichondrium Composite (TCPC) graft with Temporalis Fascia (TF) graft in patients who undergoing surgery for chronic otitis media - squamous type.MethodsPatients aged 13 years and above with diagnosis of chronic otitis media - squamous type undergoing modified radical mastoidectomy, either primary or revision surgery with grafting of tympanic membrane (TM) and patients undergoing excision of postero-superior retraction pocket (PSRP) were included in this study. Patients were divided in two groups: Group A-patients undergoing TCPC graft and Group B -patients undergoing TF graft. Graft uptake results were assessed between 8-12 weeks of surgery.ResultsIn both Groups there were 30 patients each. In Group A successful graft uptake was seen in 27 patients (90 %) and failure of graft uptake was seen in 3 patients(10 %). In Group B successful graft uptake was seen in 28 patients (93.3 %) and failure in 2 patients (6.67 %).Out of the total 60 patients, 11 patients had PSRP. All 6 patients with PSRP in Group A had successful graft uptake and no retraction. Among the 5 patients with PSRP in Group B all patients had sucessful graft uptake, however, in 2 patients retraction of the tympanic membrane was seen similar to the preoperative findings.ConclusionsThere was no statistical difference (p = 0.433) between the use of temporalis fascia or tragal cartilage perichondrium in patients undergoing surgery for chronic otitis media - squamous type.

Retraction pocket excision with cartilage grafting as a preventive surgery for cholesteatoma

“…Considering the material used for reconstruction of the TM, many studies demonstrate that there is no statistical difference in the outcome by using as a graft the temporalis fascia or a cartilage graft ( Dornhoffer, 2006 , Khalilullah et al., 2016 , Mansour et al., 2006 ). Traditionally though, the latter is preferred for its intrinsic strength, which is greater than the one of the temporalis fascia ( Kasbekar et al., 2014 ) and for its higher mechanical stability under negative pressure changes, which are frequent in the middle ear, especially in cases of tubal dysfunction, adhesive processes, tympanic fibrosis and general defects of the TM ( Shin et al., 2007 ).…”

Development of electrospun, biomimetic tympanic membrane implants with tunable mechanical and oscillatory properties for myringoplasty

“…4 These materials exhibit varying acousto-mechanical properties that rely on the donor as well as the skills of the surgeon and a complete restoration of the hearing capability is rarely achieved. [5][6][7][8][9][10] Additionally, these autologous materials are accompanied by various drawbacks like donor site morbidity and limitations of harvesting sites.…”

Biomimetic Tympanic Membrane Replacement Made by Melt Electrowriting

“…[ 5 ] Disadvantageously, the acoustic properties are significantly deteriorated, as the vibrational behavior of cartilage is different to that of perichondrium, fascia or the TM. [ 3,5 ]…”

“…[3,4] However, when thin layers of autologous cartilage are used, the stability of the reconstruction is higher, so that retractions and new perforations are rare. [5] Disadvantageously, the acoustic properties are significantly deteriorated, as the vibrational behavior of cartilage is different to that of perichondrium, fascia or the TM. [3,5] A crucial aspect besides the effect of employing a different material within the TM, is the preparation of autografts harvested from cartilage and perichondrium.…”

“…[5] Disadvantageously, the acoustic properties are significantly deteriorated, as the vibrational behavior of cartilage is different to that of perichondrium, fascia or the TM. [3,5] A crucial aspect besides the effect of employing a different material within the TM, is the preparation of autografts harvested from cartilage and perichondrium. Briefly, the tissues are cut by hand during the surgery leading to unpredictable outcomes as the thickness differs, ranging commonly from 300 up to 500 µm.…”