Comparison of Results of Myringoplasty with Temporalis Fascia and Perichondrial: Cartilage Composite Graft in High Risk Perforations

Authors

  • Rahul K. Jaiswal
  • Anup Dhungana
  • Ratnadeep Ghosh
  • Niranjan Kumar
  • Apala Lahiri
  • Hari Bhattarai

DOI:

https://doi.org/10.37506/ijphrd.v14i3.19385

Keywords:

: Myringoplasty, chronic otitis media, high risk perforation, temporalis fascia, perichondrium - cartilage, pure tone audiometry.

Abstract

Background: The objectives of this study were to compare the graft uptake and post-operative hearing results
of underlay myringoplasty with temporalis fascia and perichondrial-cartilage composite graft in high risk
perforations.
Materials & Methods: Patients of ages of 13 years and above with diagnosis of chronic otitis media – mucosal type
with high risk perforations undergoing myringoplasty were included. Criteria of high risk were >50% perforation
of tympanic membrane, revision cases, absent/eroded handle of malleus, oedematous/unhealthy middle ear
mucosa and marginal perforation of any size. Pure tone audiometry was done within 1 week before surgery.
Seventy cases included for myringoplasty were randomly allocated by lottery method into two groups with 35
cases each in temporalis fascia group and perichondrial - cartilage composite graft group. After 6 weeks graft
uptake results were assessed and post-operative hearing was evaluated and compared within and between the
groups.
Results: Graft uptake rates in temporalis fascia group and perichodrial - cartilage composite graft group were
88.57% and 91.43%, respectively with no statistically significant difference between the groups (p = 0.69). The
mean pre- and post-operative air bone gaps in temporalis fascia group were 31.81 ± 10.49 dB and 17.87 ± 7.96 dB.
The mean pre- and post-operative air bone gaps in perichondrial - cartilage composite group were 35.19 ±7.26 dB
and 22.62 ± 8.77 dB. These differences in both the groups were statistically highly significant (p < 0.001) showing
improvement in the hearing after surgery. The mean post-operative ABG gains were 13.94 ± 8.36 dB and 12.57 ±
8.21 dB in temporalis fascia and perichondrial - cartilage composite groups respectively.

Conclusion: The graft uptake rates and hearing results after perichondrial - cartilage composite graft are similar to
those of temporalis fascia graft. Perichondrial- cartilage composite graft even though more rigid and thicker than
temporalis fascia did not affect post-operative hearing results adversely

Author Biographies

Rahul K. Jaiswal

Assistant Professor, Department of ENT, ICARE Institute of Medical Sciences & Research, Balughata,
Haldia, West Bengal

Anup Dhungana

Ex-PGT, Department of ENT, Ganesh Man Singh Memorial Academy for ENT,Head and Neck Studies, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj,Kathmandu, Nepal,

Ratnadeep Ghosh

Professor, Department of ENT, ICARE Institute of Medical Sciences & Research,
Balughata, Haldia, W. B.

Niranjan Kumar

Professor, Department of Pharmacology, Shree Narayan Medical Institute & Hospital, Mahaveer Nagar, Bherdari, Bihar

Apala Lahiri

PGT, Department of ENT, ICARE Institute of Medical Sciences & Research, Balughata, Haldia, W.B.

Hari Bhattarai

Professor and Head, Department of ENT, Ganesh ManSingh Memorial Academy for ENT, Head and Neck Studies, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu, Nepa

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Published

2023-06-21

How to Cite

Rahul K. Jaiswal, Anup Dhungana, Ratnadeep Ghosh, Niranjan Kumar, Apala Lahiri, & Hari Bhattarai. (2023). Comparison of Results of Myringoplasty with Temporalis Fascia and Perichondrial: Cartilage Composite Graft in High Risk Perforations. Indian Journal of Public Health Research & Development, 14(3), 189–195. https://doi.org/10.37506/ijphrd.v14i3.19385