RELATIONSHIP BETWEEN THE DURATION OF DISEASE AND THE OUTCOME OF TYMPANOPLASTY USING TEMPORALIS FASCIA AND TRAGAL CARTILAGE

Main Article Content

Dr. Sravanthi Puvvada
Dr. K.N. Praveen Kumar
Dr. M. Kalidass
Dr. M. Kumar

Keywords

Pure Tone Audiometry, Temporalis Fascia, Tragal Cartilage, Tympanoplasty.

Abstract

Objective: To study the results of Tympanoplasty done using fascia over temporalis muscle and tragal cartilage, the comparison was done in terms of graft uptake and audiological outcome and study the relationship between duration of ear discharge and graft uptake in Tympanoplasty.


Methods: A sample of 100 patients with chronic otitis media-mucosal disease were enrolled in the study. The patients were randomly assigned to either the tragal cartilage group (Group A) or the temporalis fascia (Group B). Patients underwent Tympanoplasty with cartilage or temporalis fascia graft. A comparison was made among the two groups according to the air-bone gap in pure tone audiogram done before and after surgery and the tympanic membrane status in the post-operative period.


Results: In our study, graft uptake of the cartilage group is 88% which is 44 out of 50 patients, and the temporalis fascia group is 45 out of 50 (90%). Duration of ear discharge does not affect graft uptake in Tympanoplasty. The air-bone gap gain between the two groups shows p-value= 0.3, which is statistically insignificant. So, it proves that there is no significant difference in terms of audiological gain achieved irrespective of the graft material used in Tympanoplasty.


 Conclusion: The present study shows that the duration of ear discharge does not affect graft uptake in Tympanoplasty. Our study shows no significant difference neither in the surgical success rate of graft uptake nor hearing gain between the two groups.

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References

1. Zephania Saitabau Abraham, Daudi Ntunaguzi, Aveline Aloyce Kahinga, Kassim Babu Mapondella, Enica Richard Massawe, Emmanuel James Nkuwi et al. Prevalence and etiological agents for chronic suppurative otitis media in a tertiary hospital in Tanzania. BMC Res Notes 2019;12:429.
2. Surgery of the ear: Glasscock & Shambaugh 5th edn. Chapter 24 page: 466, chapter 20 pages: 400,405,414-6.
3. Sheehy JL, Anderson RG. Myringoplasty. A review of 472 cases. Ann Otol Rhinol Laryngol 1980; 89:331-334.
4. Buckingham RA. Fascia and perichondrium atrophy in tympanoplasty and recurrent middle ear atelectasis. Ann Otol Rhinol Laryngol 1992;101:755-8.
5. Snezana D. Jesic, Milovan V. Dimitrijevic, Vladimir S. Nesic, Ana D. Jotic, Nikola A. Slijepcevic. Temporalis fascia graft perforation and retraction after tympanoplasty for chronic tubotympanic otitis and attic retraction pockets: factors associated with recurrence. Arch Otolaryngol Head Neck Surg 2011;137:139-43.
6. Booth JB. Myringoplasty: the lessons of failure. J Laryngol Otol 1974;88:1223-35.
7. Mirko Tos. Cartilage tympanoplasty methods: Proposal of a classification. Otolaryngology–Head and Neck Surgery 2008;139:747-58.
8. M Yung. Cartilage tympanoplasty: literature review The Journal of Laryngology & Otology 2008;122:663-72.
9. Yakup Yegin,Mustafa Çelik,Arzu Karaman Koç,Levent Küfeciler,Mustafa Suphi Elbistanlı,Fatma Tülin Kayhan. Comparison of temporalis fascia muscle and full-thickness cartilage grafts in type 1 pediatric tympanoplasties Braz. j. otorhinolaryngol 2016.82(6).
10. M. Cavaliere, G. Mottola, M. Rondinelli, M. Iemma. Tragal cartilage in tympanoplasty: anatomic and functional results in 306 cases. Acta Otorhinolaryngologica Italica 2009;29:27-32.
11. Pinar E, Sadullahoglu K, Calli C, Onel S. Evaluation of prognostic factors and middle ear risk index in Tympanoplasty. Otolaryngol Head Neck Surg 2008;139:386-90.
12. Mehti Salviz, Ozlem Bayram, Ali Alper Bayram, Hasan Huseyin Balikci, Tzemal Chatzi, Ceki Paltura, et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx 2015;42(1):20-3.
13. John Dornhoffer. Cartilage tympanoplasty: indications, techniques, and outcomes in a 1,000-patient series. Laryngoscope 2003;113(11):1844-56.
14. Ben Gamra, C Mbarek, K Khammassi, N Methlouthi, H Ouni, I Hariga et al. Cartilage graft in type I tympanoplasty: audiological and otological outcome. Eur Arch Otorhinolaryngol 2008;265(7):739-742.
15. Iacovou E, Vlastarako PV, Panagiotakopoulou A, Chrysostomou M, Kandiloros D, Adamopoulos G et al. Effect of type I Tympanoplasty on the resonant frequency of the middle ear: comparison between chondro tympanoplasty and temporalis fascia grafting. J Otolaryngol Head Neck Surg 2012;41(1):14-19.
16. Emily Iacovou, Petros V Vlastarakos, George Papacharalampous, Efthymios Kyrodimos, Thomas P Nikolopoulos. Is cartilage better than temporalis muscle fascia in type I tympanoplasty? Implications for current surgical practice. Eur Arch Otorhinolaryngol 2013;270(11):2803-13.
17. Matthew Yung 1, Senthilnathan Vivekanandan, Philip Smith. A randomized study comparing fascia and cartilage grafts in myringoplasty.Ann Otol Rhinol Laryngol. 2011;120(8):535-541.
18. Mir Mohammad Jalali, Masoud Motasaddi, Ali Kouhi, Sasan Dabiri, Robabeh Soleimani. Comparison of Cartilage with Temporalis Fascia Tympanoplasty: A Meta-Analysis of Comparative Studies. Laryngoscope 2017;127(9):2139-2148.
19. Shwan H Mohamad, Imran Khan, S S Musheer Hussain. Is Cartilage Tympanoplasty More Effective Than Fascia Tympanoplasty? A Systematic Review. Otology & Neurotology 2012;33:699-705.
20. Sarah A Lyons, Tanly Su, Linda E T Vissers, Jeroen P M Peters, Adriana L Smit, Wilko Grolman. Fascia Compared to One-Piece Composite Cartilage-Perichondrium Grafting for Tympanoplasty. Laryngoscope, July 2016;126:1662–1670.
21. Katsura H, Sakagami M, Tsuji K, Muto T, Okunaka M, Mishiro Y et al. Reevaluation of bilateral same-day surgery for bilateral perforated chronic otitis media. Otol Neurotol 2005;26(5):842-845.