Graft Uptake and Hearing After Endoscopic Palisade Cartilage Myringoplasty at Nepal Medical College Teaching Hospital

Abstract

Background: Chronic otitis media mucosal type is commonly encountered in otorhinolaryngology. Myringoplasty is a common surgery performed to repair the tympanic membrane (TM). Management of subtotal perforation of the TM has become better with the use of endoscopes. The use of cartilage as palisade for repair of the TM has become popular. The aim of the study was to assess graft uptake and hearing after endoscopic palisade myringoplasty. Methods: A prospective study was conducted in the otorhinolaryngology department from April, 2022 to January, 2023. The study included 65 patients, aged 21 years and above diagnosed as chronic otitis media mucosal type, inactive with subtotal perforation and conductive hearing loss. History, clinical examination, otoscopy, tuning fork tests, examination under microscope (EUM) were conducted preoperatively. All patients underwent endoscopic palisade cartilage myringoplasty. Pre-operative and post-operative pure tone audiograms of the patients were done to record the air conduction threshold (ACT), bone conduction threshold (BCT) and air bone gap (ABG). SPSS 16 software was used for analysis of results. The statistical tests used for analysis was paired t-test, level of statistical significance was set at the P < 0.05. Results: The mean age of the patients was 28.51±7.20 years with a female preponderance (57.9%). Graft uptake following surgery was 91.9%. There was significant reduction (p<0.001) in the air bone gap postoperatively that suggested improvement in hearing. The mean hearing gain was 13.91±6.79 dB. Conclusions: The use of endoscopic palisade cartilage myringoplasty to correct subtotal perforation has good results in terms of graft uptake and hearing improvement.