A Comparative Study on Results of Surgical Procedure i.e. Tympanoplasty by Using Temporalis Fascia and Cartilage Island as Autologous Grafting Material (original) (raw)
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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.
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.
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...
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...
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...
Journal of Mahatma Gandhi University of Medical Sciences and Technology, 2019
Background: This study was conducted to demonstrate a comparative study about graft uptake rate and hearing gain between cartilage shield tympanoplasty (CST) and tympanoplasty with temporalis fascia (TF) in patients with chronic otitis media (tubotympanic disease). Materials and methods: Cartilage shield tympanoplasty and TF tympanoplasty were studied in two groups. Group I containing 65 cases and group II having 80 cases with central perforations. Graft uptake rates and hearing improvement at 3 months postoperative follow-up were compared. Results: The graft uptake rates were 98.46 and 90% in groups I and II, respectively, at the end of 3 months. In total, 88% in group II and 90% in group I had improvement in hearing at 3 months of surgery. Conclusion: Conchal cartilage can be used effectively as a graft material for cartilage shield tympanoplasty. It has also shown superior autograft as compared to TF, not only because of better graft uptake rates and less partial failure rates but also due to the significant hearing improvement, talking in terms of mean AB gap in both types of graft materials.
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...
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'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.
Island cartilage vs temporalis fascia in type 1 tympanoplasty: A prospective study
Acta otorrinolaringologica espanola, 2018
Objective: (1) To compare the results of graft take-up and audiological outcome of temporalis fascia versus island cartilage graft in type 1 tympanoplasty. (2) To compare the rate of postoperative retraction of neotympanum in both. Methods: A prospective study was conducted on 70 patients of ages ranging from 11 to 50 years with dry subtotal perforation. 35 underwent island cartilage tympanoplasty and 35 underwent type 1 tympanoplasty using temporalis fascia graft. Graft acceptance rates and post-operative audiograms were compared. Results: At one year follow up, the graft take-up rate for temporalis fascia and island cartilage graft were found to be 82.9% and 97.1% respectively, which was found to be statistically significant (p < 0.05). In the temporalis fascia group, two out of 35 patients (5.7%) had retraction of the neo tympanum. There was no incidence of retraction using island cartilage graft. There was no significant difference in the postoperative air-bone gap gain between temporalis fascia graft and island cartilage graft. Conclusion: Island cartilage tympanoplasty shows a high degree of reliability in high risk cases. It has a higher graft take-up rate with no incidence of retraction of neotympanum. Moreover, it provided significant hearing improvement in our patients.
Background and objectives : According to the Wullstein classification type 1 tympanoplasty is the defect in the tympanic membrane in the forms perforation which is repaired with a graft. It is also called Myringoplasty.Various graft materials have been used to close ear drum (tympanic membrane) perforations. Study was tocompare the outcomes of type 1 tympanoplasty with graft materials used by temporalis fascia and cartilage. Materials and Method: A retrospective review was undertaken of primary type 1 tympanoplasties using pieces of cartilages from the tragus, concha and temporalis fascia from October 2015 to October 2017. The study was conducted in the department Otorhinolaryngology, Result: The total numbers of cases were 48.Average operated patients age group were 15-52. The numbers of male patients were 25 and female 23. In total, 31cases were operated on using tragal and conchal cartilage graft a nd rest of the 17 cases using temporalis fascia.At the 6 months of followup, successful closure of the tympanic membrane was achieved in 100% of cases in cartilage group and 82.35% in the temporalis fascia group. The average air bone gap in the cartilages group was7±2.23 dB and 8.45±2.35 dB in the temporalis fascia group in the 6 months of follow-ups. Conclusion: The overall success rate for type 1 cartilage tympanoplasty is higher than the temporalis fascia tympanoplasty.