Island cartilage vs temporalis fascia in type 1 tympanoplasty: A prospective study (original) (raw)
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Journal of Clinical Medicine
Background: To compare the functional and anatomical results of two different types of grafts in type 1 tympanoplasty (TPL I). Methods: A retrospective comparative bicentric study was conducted on patients treated with TPL I using temporal fascia or tragal cartilage. We evaluated the functional and anatomical results with intergroup and intragroup analyses. Variables predicting long-term success were also evaluated. Results: A total of 142 patients (98 fascia graft vs. 44 cartilage) were initially assessed, with a mean follow-up of 67.1 ± 3.2 months. No significant differences were observed between the two groups on the intergroup analysis of age, gender, ear side, or pre-operative hearing data (all p > 0.05). At the intragroup analysis of auditory outcomes, both groups demonstrated a significant improvement in post-operative air conduction, with greater gain for the fascia group at 6 months follow-up (p < 0.001 for both); however, at long-term follow-up, cartilage demonstrate...
International journal of scientific research, 2021
Objective: To compared the outcome of Type 1 tympanoplasty with cartilage-perichondrium graft in comparison with temporalis fascia graft in terms of post-operative graft take-up and hearing results. Materials and Methods: A prospective observational study among 80 patients between 15 and 60 years of age satisfying the inclusion criteria with complaints of ear discharge and hearing loss due to COM - mucosal type was conducted. Patients were grouped in two groups of 40 patients each. Group A patients underwent Type 1 tympanoplasty with temporalis fascia and Group B with cartilage-perichondrium graft. Patients were followed up for graft uptake, hearing improvement and rate of failure are compared for both the grafts. Graft uptake was assessed at the end of the 1st month, 3rd month, and 6th month, and hearing was assessed at the end of the 6th month with pure tone audiometry. Results: Patients with temporalis fascia graft showed a take-up rate of 80% and cartilage-perichondrium graft of...
European Archives of Oto-Rhino-Laryngology, 2012
Our objective is to compare hearing and graft take results of temporal muscle fascia tympanoplasty and cartilage reinforcement tympanoplasty. Seventy seven patients are classified into two groups: Group 1 included 37 patients for whom cartilage graft, harvested from symba concha, is used as reinforcement under temporalis muscle fascia anteriorly and Group 2 included 40 patients for whom only temporalis muscle fascia is used in type 1 tympanoplasty. A pure-tone audiometry is done within 1 week prior to surgery and at 6 months postoperatively. There is statistically significant difference between postoperative graft take results among groups. In both groups postoperative anterior TM perforation is encountered most commonly. Success rate of cartilage reinforcement tympanoplasty in revision patients is 100% but temporal muscle fascia tympanoplasty&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s is 66%. There is no statistically significant difference between preoperative and postoperative air conduction gain of TM intact patients. The results indicated that Cartilage reinforcement myringoplasty technique under anterior of the temporal muscle fascia significantly increases the graft take ratios in high-risk perforations and it also does not affect hearing levels. Therefore, the authors suggest usage of cartilage reinforcement tympanoplasty technique under anterior of the temporal muscle fascia which is an easy and applicable technique to increase graft take ratios, particularly in patients with preoperative anterior and subtotal TM perforations.
Cartilage Tympanoplasty: Is it more effective than temporalis fascia grafting for tympanoplasty?
Otolaryngology online journal, 2015
Chronic suppurative otitis media is a disease which is a major cause of morbidity in our country. A large proportion of these patients have safe (mucosal) chronic suppurative otitis media. It leads to otorrhoea and deafness which hampers productivity of many individu-als. Otolaryngologist play an important role in its correction and amelioration by con-servative or operative procedures. One such procedure is tympanoplasty. AIMS AND OBJECTIVES 1. To evaluate improvement in hearing following tympanoplasty using temporalis fascia graft and cartilage island graft at 8 weeks after surgery. 2. Graft status after tympanoplasty using temporalis fascia graft and cartilage island graft. 3. Assess other complications after surgery in both groups. This study was conducted in the Department of Otorhinolaryngology and Head and Neck Sur-gery, ST. STEPHEN’S HOSPITAL, DELHI between November 2010 to November 2012. INCLUSION CRITERIA 1. Includes patient in the age group of 20-40 years, having good gen...
Role of cartilage graft in type 1 tympanoplasty: audiological and otologic outcomes
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: Temporalis fascia is the most commonly used graft material for the tympanic membrane perforations. Due to high failure rate of temporalis fascia in adhesive otitis media, large perforations and advanced middle ear pathology alternate graft materials which are more rigid and resistant to infection are being used. Cartilage graft has shown to be a promising graft material in such cases. The purpose of this study was to evaluate the functional and anatomic results with cartilage graft in type 1 tympanoplasty.Methods: The present prospective study was conducted among 40 patients of chronic otitis media between 11-60 years of age requiring tympanoplasty in department of ear, nose and throat (ENT) in Government Medical College and Rajindra Hospital, Patiala. Results: The overall success rate of type 1 cartilage tympanoplasty was 85% in terms of perforation closure and post operative pure tone audiometry (PTA) at 6 weeks was 37.24 and at 12 weeks PTA was 34.27 The p value was ...
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: Temporalis fascia and cartilage are the most commonly used graft materials, though contradictory reports are available in literature as regards their efficacy. The purpose of this study was to compare graft acceptance and auditory outcomes of tympanoplasty using cartilage versus temporalis fascia as graft material.Methods: This prospective study included 40 consecutive cases of chronic otitis media in a tertiary care centre randomised in two groups of 20 patients each to be subjected to tympanoplasty using either tragal cartilage-perichondrium or temporalis fascia graft from January 2011 to November 2012. Graft uptake rates and subjective as well as objective hearing improvement at 2 months and 6 months postoperative follow-up were compared. Results: The mean age of presentation was 34.4 years (range 15-60 years). At 2 months post operatively, the graft uptake was better with tragal cartilage group (95%) than temporalis fascia (90%), while at the end of 6 months graft u...
A Comparative Study of Tympanoplasty Using Sliced Cartilage Graft vs. Temporalis Fascia Graft
Journal of Evidence Based Medicine and Healthcare, 2018
BACKGROUND The objective of the study was to compare the hearing improvement after using sliced cartilage graft with that of temporalis fascia and to compare the graft take-up between the two graft materials. MATERIALS AND METHODS A prospective clinical study including 60 patients with chronic mucosal otitis media, who were selected randomly from the outpatient department, after obtaining their consent were divided into 2 groups of 30 each, and evaluated according the study protocol. Their pre-operative audiometry was recorded and both groups of patients underwent surgery with one of the graft materials-temporalis fascia or sliced tragal cartilage with a thickness of 0.5 mm. All patients were regularly followed up and post-operative audiometry was done at 3 months. The hearing improvement in the form of closure of air-bone-gap and graft take-up was analysed statistically. RESULTS The temporalis fascia graft group had a pre-operative ABG of 22.33 ± 6.24 dB and post-operative ABG of 12.33 ± 4.72 dB with hearing improvement of 10.00 dB. The sliced cartilage graft group had a pre-operative ABG of 20.77 ± 5.75 dB and postoperative ABG of 10.50 ± 4.46 dB with hearing improvement of 10.27 dB. In the temporalis fascia group, 28 (93.3%) patients had good graft take-up and in the sliced cartilage group 29 (96.7%) had good graft take-up. There was statistically significant hearing improvement in both of our study groups but there was no statistically significant difference between the two groups. There was no statistically significant difference in graft take-up also. CONCLUSION Sliced cartilage graft is a good auto-graft material in tympanoplasty, which can give good hearing improvement and has good graft take-up, which is comparable with that of temporalis fascia.
Aim: The present study aims to evaluate graft uptake rates and audiological results of type I tympanoplasty using sliced conchal cartilage reinforced with temporalis muscle fascia versus temporalis muscle fascia graft. Material & Methods: A retrospective study involving a total of 40 patients presenting with dry central perforation with intact and mobile ossicular chain and conductive type of hearing loss, visiting ENT outpatient department of Government Medical College, Amritsar were included in the study. These were randomly divided into two groups of twenty patients each with Group I patients undergoing Type I tympanoplasty with temporalis muscle fascia and Group II patients with sliced conchal cartilage as graft reinforced with temporalis fascia. A pure-tone audiometry was done within 1 week prior to surgery and at 3 months postoperatively to evaluate hearing status. Results: Graft take up rate in Group I was 85% while Group II patients had a take up rate of 95% (P < 0.01). The mean percentage improvement in pre-op pure tone average (PTA) and post-op PTA values in Group I and II was 14.91 (SD ± 9.741) and 14.48 (SD ± 9.366) respectively (p > 0.05). Conclusions: Sliced conchal cartilage reinforced with temporalis fascia is a reliable technique for tympanoplasty, especially in large perforations with better graft uptake rates compared to temporalis fascia without affecting audiometric results.
Comparative study of cartilage tympanoplasty with temporalis fascia tympanoplasty
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: The aim of our study is comparison of effectiveness of cartilage (conchal or tragal) tympanoplasty with temporalis fascia tympanoplasty in terms of graft uptake and audiological outcomes. Help of following databases were taken: MEDLINE, emedicine, Google scholar, and the PubMed.Methods: We studied the outcome of two different type of graft material (cartilage and temporalis fascia). Who underwent type 1 tympanoplasty at department of otorhinolaryngology, RUHS College of Medical Sciences, Jaipur from November 2015 to November 2018. Total 80 patients were divided in two groups, 40 patients underwent cartilage grafting while 40 patient’s tympanoplasty was done using temporalis fascia graft. Results: The successful graft uptake rate for the fascia group was 90%, and that for the cartilage group was 97.5%. Though initial audiological improvements were better in fascia graft group, long term results were similar in both groups.Conclusions: The use of cartilage tympanoplasty h...
2015
Introduction: The quest for an ideal graft material for tympanic membrane repair is an evolutionary process. Temporalis fascia, though being most commonly used does not seem to withstand middle ear pressure changes in the long run. Use of tragal cartilage-perichondrium (composite graft) has come up as a graft material of choice offering resistance from pressure changes, yet being acoustically acceptable. Aims and Objective: The present study was undertaken to compare the results of autologous tissues like temporalis fascia, tragal cartilage-perichondrium (composite graft), as graft materials for the Type I tympanoplasty. Materials and Methods: A total of 130 cases of chronic otitis media were considered in the study without any age and sex bias. Two groups were created of these 130 cases, wherein temporalis fascia graft was used in Group A while tragal cartilageperichondrium (composite graft) was used in Group B. The results were evaluated in the form of graft take-up and acoustic g...