Temporal Fascia Versus Tragal Perichondrial Graft in Myringoplasty and Tympanoplasty
International Journal of Otorhinolaryngology
Volume 5, Issue 1, June 2019, Pages: 15-19
Received: Jan. 9, 2019;
Accepted: Mar. 28, 2019;
Published: May 15, 2019
Views 49 Downloads 17
Tallat Najeeb, Department of Otorhinolaryngology, Fazaia Medical College, Islamabad, Pakistan
Wajahat Ullah Khan Bangash, Department of Otorhinolaryngology, Islamabad Medical and Dental College, Islamabad, Pakistan
Nisa Siddiqui, Islamabad Medical and Dental College, Islamabad, Pakistan
The objective of this study is to compare the results of tympanoplastywith underlay technique with respect to graft uptake, hearing improvement and complications. Thestudy was conducted between January 2006 & January 2018 at Haider clinic, Kulsum international Hospital Islamabad, MaroofInternational Hospital, Social security Hospital Islamabad and PAF hospital Islamabad. Sampling was done by non-probability convenient sampling type by random selection. Total of 1677 patients were selected had Tympanoplasty type 1. All had dry central perforations of different sizes for more than 3 months and conductive hearing loss of less than 40dB with patent Eustachian tube. Informed consent was taken from patients andethical committee. Patients with sensorineural hearing loss and with severe nasal pathology were excluded. Patients were divided into 2 groups, A and B, were subjected totympanoplasty by underlay technique by the same group of surgeons. In group A, temporalis fascia graft and in group B tragalperichondrial graft was used. Postoperative audiometry was done after 3 months in each case to calculate air bone gap. In our study there were 62% males and 38% females, mean age was 32.5. In Group A, 689 patients hadtympanoplasty with temporalis fascia and in group B 988 patients with chondro-perichondrial graft. Medialization was seen in 30(4.3%) patients in Group A and in 10(1%) in group B. Persistent Perforations happened in 32(4.6%) patients in group A and in 8(0.8%) patients group B. Graft uptake success rate using temporalis fascia was 85.9% and was 97.4% with Chondro-perichondrial graft. Hearing improvement was seen in 627(91%) patients in group A and 970(98%) patients in group B. Statistical analysis of the data was done using SPSS 16. Temporalis fascia and tragal perichondrium both are excellent material to repair tympanic membrane. Graft uptake rate and hearing improvement are better in perichondrial graft.
Wajahat Ullah Khan Bangash,
Temporal Fascia Versus Tragal Perichondrial Graft in Myringoplasty and Tympanoplasty, International Journal of Otorhinolaryngology.
Vol. 5, No. 1,
2019, pp. 15-19.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Rakesh K, Rajesh K, YugeshA et al. Comparative study of underlay tympanoplastywithtemporalis fascia and tragal perichondrium. IOSR Journal of Medical Sciences (IOSR-JDMS). 2014; 13(5): 89-98.
Sengupta A, Basak B. A study on outcome of underlay, overlay and combinedtechniqueofmyringoplasty. IndOtolaryngol Head neck Surg. 2011;64(1):63-66.
Jyoti PD. Comparative study of underlay tympanoplasty with temporalis fascia and tragal perichondrium. Ind Oto laryngol Head neck Surg. 2007; 116-119.
Pardeep P, Abhimanyu A, Vellore P etal. Comparison of Temporalis Fascia and fullThickness Cartilage palisades in type –I underlay tympanoplasty for large/subtotal perforations. Iran J Otorhinolaryngol. 2017;29(91): 63-68.
Iacovou E, Vlastarakos PV, Panagiotakopoulou A, Chrysostomou M, Kandiloros D, Adamopoulos G. Effect of type I tympanoplastyon the resonant frequency of the middle ear: comparison between chondrotympanoplasty and fascia grafting. Otolaryngol Head Neck Surg. 2012;41(1): 14-9.
Kalciglu MT, Tan M, Croo A. comparison between cartilage and fascia grafts in typeI tympanoplasty. B-ENT. 2013;9(3):235-9.
Vashishth A, Mathur NN, Choudhary SR, Bhardwaj A. Clinical advantages ofcartilagepalisades over temporalis fascia in type I tympanoplasty. AurisNasus Larynx. 2014;41(5):422-7.
Dὓndar R, Soy FK, Kulduk E, Muluk NB, Cingi C. A new grafting technique fortympanoplasty: tympanoplasty with a boomerang-shaped chondroperichondrial graft. Eur Arch Otorhinolaryngol. 2014; 271(10): 2687-94.
Shwan H, Imran M K and S M Hussain. Is cartilage tympanoplasty more effectivethanfasciatympanoplasty? A systemic review. OtolNeurotol. 2012;33:699-705.
Onal K, Arslanoglu S, Oncel S, et al. Perichondrium/cartilage island flap andtemporalismuscle fascia in type I tympanoplasty. J Otolaryngol Head Neck Surg. 2011;40:295-9.
Demirpehlivan IA, Onal K, Aslanoglu S, et al. comparison of different tympanicmembrane reconstruction techniques in type I tympanoplasty. Eur Arch Otorhinolaryngol. 2011;268:471-4.
Marcos R F, Thiago CO. The role of different types of grafts in tympanoplasty. Braz. J. otorhinolaryngology. 2014;80(4).
Friedmzn AB, Gluth MB, MOOR PC et al. Out come of cartilage tympanoplasty inpediatric population. Otolaryngol Head Neck Surgery. 2013; 148:297-301.
Duval M, Grimmer J. F, Meier J et al. The effects of age in pediatric tympanoplastyoutcomes: Acomparison of pre school and older children. Int J PediatrOtolaryngol. 2015;79: 336-341.
Chhapola S, Matta I. Cartilage perichondrium:an ideal graft material. Indian JOtolaryngol Head Neck Surg. 2012;64:208-213.
Yilmaz MS, Guven M, Kayabasuglu G, et al. Comparison of anatomic and hearingoutcomes of cartilage type I tympanoplasty in pediatric and adult patients. EUR Otolaryngol. 2015;272:557-562.
Khan MM. Average thickness of tragal cartilage for slicing technique in tympanoplasty. J laryngol Otol. 2015;129:435-439.
Callioglu E. E, Ceylan B. T, Kuran. G et al. Cartilage graft or fascia in tympanoplasty in patients with low middle ear risk index. Eur Arch Otolaryngol. 2013;270:2833-2837.