Evaluation of graft uptake using temporalis fascia and cartilage perichondrium supplemented with autologous platelet rich plasma in tympanoplasty (original) (raw)
Related papers
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...
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...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020
Chronic suppurative otitis media is a very common condition in the practice of otolaryngology both in developed as well as developing countries. Perforation of the tympanic membrane which results in recurrent otorrhea and hearing loss. It affects both sexes and all age groups. The incidence of CSOM continues to be high in developing countries because of poor socioeconomic standards, poor nutrition, lack of health education etc. and so the demand for corrective surgery is ever-increasing. Tympanoplasty refers to any operation involving
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...
The Egyptian Journal of Otolaryngology, 2021
Various grafting materials and different techniques have been used for myringoplasty. The aim of the study was to compare the result of tympanoplasty in patients with safe-type chronic suppurative otitis media using periosteum versus tragal cartilage with perichondrium grafts through pre- and postoperative clinical and audiological evaluation. There was statistically significant difference for mean air-bone gap for group A (23.4 dB ± 0.03 SD) when compared to group B (19.4 dB ± 4.2 SD) with P value 0.103. Also, there was statistically significant difference in the hearing gain in group A after 6 months (25.53 dB ± 6.26 SD) when compared to group B (19.63 dB ± 9.76 SD) and the P value was 0.003. Graft taken was superior in the periosteal group (95%), compared to the cartilage grafts (90%). Tympanoplasty with periosteal graft showed better hearing results and high rates of graft taken than tragal cartilage grafts.
Cartilage graft in type I tympanoplasty: audiological and otological outcome
European Archives of Oto-rhino-laryngology, 2008
The aim of this study is to evaluate anatomical and audiological results of cartilage tympanoplasty compared to fascia tympanoplasty in the reconstruction of tympanic membrane perforations. We carry a retrospective study about 380 patients operated in our department between 1998 and 2005. Patients were classified into two groups: 90 (23.6%) undergo cartilage tympanoplasty and 290 (76.4%) fascia tympanoplasty. In each group, we calculated the average of pre and postoperative air bone gap (ABG) and the average air conduction gain (ACG) at 250–4,000 Hz. The surgical technique is explained in detail. We detail and analyze the audiological and anatomical results in each group. Successful closure of the tympanic membrane perforation was achieved in 97% of the cartilage group as compared to 94% of the fascia group. The average ACG was 21 ± 11 dB in cartilage group and 20 ± 22 dB in fascia group. With an average follow-up of 2 years, residual perforation was observed in 2.2% in cartilage group. Reperforation of fascia graft and retraction were noted in 2.1 and 1%, respectively. The authors show the great reliability of cartilage tympanoplasty to close tympanic membrane perforations. We recommend using cartilage as a first choice, especially in stable or evolutive chronic otitis media, and in recurrent perforation of the tympanic membrane.
Cartilage reinforcement graft versus fascia graft in tympanoplasty*
TURKISH JOURNAL OF MEDICAL SCIENCES
Introduction The main aim of successful tympanoplasty is to create a well aerated closed cavity after total removal of the disease. Numerous types of grafting materials have been used for closure of the tympanic membrane including fascia, periosteum, perichondrium, cartilage, vein, skin, and fat tissue (1-4). Autografts are thought to be the most compatible grafting materials with the best surgical results in tympanoplasty. Temporalis muscle fascia (TMF) is the most popular one with the ease of obtainment and the satisfactory functional and anatomical results. TMF has been used in nearly 90% of surgeries (5). Cartilage as a grafting material was popularized by Utech in the 1950s (6). It is a stable and stiff barrier when compared to fascia, particularly in atelectatic ears or eustachian tube dysfunction. Initial studies showed that cartilage is an appropriate material for grafting after cholesteatoma removal or large defects in scutum. On the other hand, the hearing results were not favorable in the preliminary reports. In this study we aimed to compare TMF and cartilage as grafting materials focusing on the hearing and anatomical outcomes in different pathologies. 2. Materials and methods 2.1. Patient population and study design A retrospective chart review was conducted for patients who had undergone tympanoplasty with/ without ossiculoplasty and/or mastoidectomy at Ankara University Otolaryngology Department from November 2006 through September 2013 with a minimum follow-up period of 6 months. The patients were divided into two main groups: grafted with TMF alone (fascia group) and TMF reinforced with cartilage (cartilage group). In the cartilage group, conchal, tragal, or cymbal cartilage was used with underlay technique together with the TMF as a part of reinforcement technique as stated by Sarac (7). An elliptic cartilage graft was harvested from the concha, tragus, or cymba with a thickness of 1-3 mm and a diameter of 1 × 1 Background/aim: The purpose of this study was to compare cartilage reinforcement graft results with temporalis fascia graft alone in terms of hearing and anatomical outcomes in tympanoplasty. Materials and methods: Patients who underwent tympanoplasty with/without ossiculoplasty and/or mastoidectomy at a university hospital from 2006 through 2013 were reviewed retrospectively. The patients were divided into those grafted with temporalis muscle fascia alone and with fascia reinforced with cartilage. The postoperative air bone gap, gain in hearing thresholds, and graft status were evaluated for each group. Results: The study subjects included 179 patients. There were 82 patients in the fascia group and 97 patients in the cartilage group. Successful hearing results were elicited in 79.2% of the fascia group and 85.5% of the cartilage group. There was no significant difference in overall graft success. The graft was intact in 82.9% of the fascia group and 86.5% of the cartilage group. Conclusion: In this comparative study the use of cartilage to reinforce the temporalis muscle fascia was analyzed, showing better hearing and anatomical results than sole use of fascia in tympanoplasty both for primary and revision cases. Thus, in the light of our results, when performing tympanoplasty we recommend the use of cartilage reinforcement grafting whenever needed and indicated.
Acta Otorhinolaryngologica Italica, 2016
SUMMARY Cartilage is one of the most preferable grafts for tympanoplasty (TPL). The anatomical and audiological results and take rates of perichondrium attached cartilage island graft in tympanoplasty (PACIT) are presented herein. One hundred ninety four ears of 191 patients (108 male, 83 female) were evaluated retrospectively in terms of the type of surgery, graft take rate and hearing results. Type I, II, and III TPL were performed in 127 (65.46%), 45 (23.20%), and 22 (11.34%) ears, respectively. The overall mean preoperative pure tone average-air bone gaps (PTA-ABGs) for TPL types were 33.74 ± 9.60, 52.58 ± 9.07, and 56.58 ± 10.27 dB HL, respectively; postoperative mean values for TPL groups were 18.55 ± 9.25, 31.21 ± 4.36, and 44.84 ± 12.45 dB HL. Postoperative hearing results showed an improvement (≥ 10 dB) in 76.81% of ears with a mean gain of 20 dB HL (range 10-40 dB). However, 19.07% of ears showed no change (< 10, ≥ 0 dB) in hearing, and hearing worsened in 4.12% of ears...
Role of Cartilage as a Graft Material for Tympanic Membrane and in Middle Ear Reconstruction
International Journal of Otolaryngology and Head & Neck Surgery, 2015
Objective: The work was planned to evaluate the results of cartilage graft in the surgical treatment of chronic suppurative otitis media. Study Design: A prospective study. Materials and Methods: The present study was a prospective study of tympanoplasties and tympanomastoid surgeries performed on 100 patients. The main outcome measures were both anatomical and functional in form of graft incorporation and postoperative hearing function. Results: Cartilage was used as tympanic membrane and/or ossicle graft in the cases. There were no immediate postoperative or long term complications of surgery except for 10 cases in which there was a failure of graft uptake. There was a 7.6-decibel (dB) improvement in mean air conduction threshold post-operatively. A mean closure of average air bone gap of 8.4 decibels (dB) was noted which was statistically significant. Conclusion: The cartilage graft is a very effective option for the repair of the conducting mechanism of the ear with good take-up rates, less chances of rejection or extrusion and very few significant complications. The thickness of cartilage creates stiffness that is more resistant than the fascia to the anatomic deformities caused by negative middle ear pressure thus improving the long term integrity of the graft.
Research Journal of Medical Sciences, 2024
A high-risk perforation refers to a situation where a revision surgery is required, the perforation occurs in front of the annulus, the perforation is draining during operation, the perforation is more than 50%, or there is a perforation on both sides. The objective of this study was to compare the outcomes of graft uptake and hearing improvement between temporalis fascia and cartilage island tympanoplasty. The surgical procedure Tympanoplasty was conducted concurrently on a total of 60 patients who were attending St. Stephen's Hospital. The patients were separated into two groups, with each group consisting of 30 patients. In Group A, the surgery involved the use of temporalis fascia, while in Group B, cartilage island was used. The status of graft was evaluated 21 days after the procedure and the hearing exam was conducted 8 weeks following the surgery. This study demonstrates that the rate of cartilage island graft uptake in patients was 96.7%, but the uptake rate in the temporalis fascia group was 90%. However, there was no statistically significant difference between the two groups (p value >0.05). The average increase in air bone gap in the cartilage island group was 12±6.37 dB, while it was 14.33±6.66 dB in the temporalis fascia group. There was no significant difference between the two groups, with a p value greater than 0.05. Based on this, it can be inferred that when it comes to tympanoplasty, both cartilage island graft and temporalis fascia are equally effective as autologous graft materials.