Myringoplasty with temporalis fascia : Analysis of 200 cases

Success Rate of Type I Tympanoplasty Using Temporalis Fascia by Underlay Technique in Safe Mucosal COM in KMCH, Katihar

Otitis media is inflammation of middle ear, commonly seen in children of school going age. Chronic otitis media is permanent abnormality of tympanic membrane most commonly as a result previous acute otitis media. Early diagnosis and management of chronic otitis media is important because it may affects hearing of child which in turn may affect cognitive development of children. This is a retrospective observational study done on 60 patients of age between 18 and 60 yrs during the period from May 2019 to November 2019 in ENT department of Katihar Medical College, Katihar, Bihar and assessed success rate of Type I Tympanoplasty using Temporalis Fascia by Underlay technique in safe mucosal COM. Success rate was 90% when preoperative dry ear was for more than one month. Graft taken up properly in 50 patients out of 60 cases i.e. 83.33%.

Effectiveness of Type I Tympanoplasty in Wet and Dry Ear in Safe Chronic Suppurative Otitis Media

The aims and objectives of the study were to compare the rate of graft uptake after type 1 tympanoplasty in wet and dry ears and also to compare the postoperative hearing improvement in wet and dry ears. It was a Non Randomized Experimental Study. This study was done in ENT OPD at Tertiary Health Care Institute of Central India. It was conducted from November 2012 to October 2014 on 86 patients having Safe Chronic Suppurative Otitis Media. The patients were divided into two groups as Dry ear group and Wet ear group. Dry ear group included patients whose ear was dry for at least 6 weeks prior to the surgery. Wet ear group included patients who had minimal mucoid discharge in the middle ear which on culture and sensitivity showed no microorganisms. Type 1 Tympanoplasty was done in all patients. Results were analyzed statistically. Complete graft uptake was seen in 86.95% cases of Dry ear group and 80% of Wet ear group and the difference was statistically insignificant. Hearing improvement was achieved in 80% cases in dry group and 67.5% cases in wet group. The difference in hearing improvement in both groups was also statistically insignificant. So conclusion was drawn that, presence of minimal mucoid ear discharge at the time of surgery does not affect the success rate of Type 1 Tympanoplasty.

Indian Perspectives on Graft Materials Used for Repair of Tympanic Membrane

INTRODUCTION

Repair of Tympanic Membrane (TM) is one of the most common surgeries performed by the otologists. Literature reveals that Indian surgeons have contributed substantially in the research on techniques and graft materials used for the repair of tympanic membrane, though no review has been written so far highlighting their contributions.

AIM

To summarize and analyse the contributions of Indian authors who have used different graft materials for repair of TM and their studies listed in Medline search.

MATERIALS AND METHODS

A literature review was conducted using a Medline search using keywords of 'myringoplasty' and 'tympanoplasty' with 'India' on 30th June 2016. A total of 243 articles were found listed onwards from year 1998. Out of these 50 articles in which type 1 tympanoplasty or myringoplasty was performed using different graft materials were selected. The content of each abstract was studied in order to identify studies related to topic.

RESULTS

Authors have experimented with a variety of tissues as graft materials. Temporalis Fascia (TF) has been most widely used in 58.6% studies as graft material. The next popular graft is tragal perichondrium. The graft take up rates varied from 68.5% to 100%, while method of reporting of hearing gain in most studies was inconsistent amongst studies, though most studies have reported achievement of serviceable hearing of < 25 dB in most patients.

CONCLUSION

TF was the most prefered material due to anatomic proximity, light material and strength. It was followed in popularity by tragal perichondrium and tragal cartilage. All graft materials have given satisfactory hearing results.