A clinical study of audiological outcome following type I tympanoplasty using temporalis fascia as graft
Abstract
Introduction: Tympanic membrane perforations caused by chronic suppurative otitis media are very frequent. Tympanoplasty is a general surgical practice for the repair of TM perforation. The aim of the present study was to evaluate the hearing outcomes following type I tympanoplasty using temporalis fascia as a graft.
Materials and Methods: This cross-sectional study was carried out in the Department of ENT. A total of n=65 patients n=35 male and n=30 female were selected. All the cases underwent tympanoplasty through post aural technique using harvested temporalis fascia as the autograft material by underlay approach. The external auditory meatus was then packed with soframycin pack. Sutures and soframycin pack was taken out on the 7th day of operation. Steroid nasal spray for 2 months along with antibiotics and decongestants which were advise for 2 weeks. The patients were followed at the one-month interval for 3 months than at 6 months.
Results: The prevailing perforations were (less than 50% of the TM) found in n=29 (44.61%) of the patients followed by medium size perforations n=21 (32.30%) and large perforations were found in n=15 (23.07%). The overall success rate of the graft was n=61 (93.84%) patients out of n=65 patients and the graft uptake was found in n=63(96.92%) of the patients. The overall improvement of hearing recorded the mean preoperative air-bone conduction in male prior to the operation was 23.5±3.2 dB and mean postoperative AB gap after 3 months was 8.61±1.7 dB and the gain was 14.89±1.50 similarly in females the mean preoperative AB conduction was 22.1±2.8 dB and mean postoperative AB conduction was 6.72±1.39 the gain was 10.60±1.41.
Conclusion: Type I tympanoplasty with temporalis fascia is reasonably successful for the treatment of central perforations with dry ears. The audiological outcomes in the form of hearing improvements were noticed in almost all of the patients.
Downloads
References
Rizer FM. Overlay versus underlay tympanoplasty. Part I: historical review of the literature. Laryngosco. 1997; 107(12 Pt 2):1-25. doi: https://doi.org/10.1097/00005537-199712001-00001.
Browning GG et al Scott-brown's otorhino-laryngology-head and neck surgery, 7th ed. 3:3421.
Khan NA. Repair of traumatic perforation of tympanic membranes by a new technique. Pak J Otolaryngol. 1992;8(177):9.
Hosamani P, Ananth L, Medikeri SB. Comparative study of efficacy of graft placement with and without anterior tagging in type one tympanoplasty for mucosal-type chronic otitis media. J Laryngol Otol. 2012;126(2): 125-130. doi: https://doi.org/10.1017/S0022215111002659.
Javed M, Khan S, Ullah H, Shah J. Onlay versus underlay myringoplasty, audiological results. Pak J Otolaryngol. 2000;16:59-60.
VrabecJT,Deskin RW,Grady JJ.Meta-analysis of pedi-atric tympanoplasty. Arch Otolaryngol Head Neck Surg. 999;125(5):530-534. doi: https://doi.org/10.1001/archotol.125.5.530.
Ashfaq M, Aasim MU, Khan N. Myringoplasty: anatomical and functional results. Pak Armed Forces Med J. 2004;54(2):155-158.
Flint PW, Haughey BH, Niparko JK, Richardson MA, Lund VJ, Robbins KT, Lesperance MM, Thomas JR. Cummings Otolaryngology-Head and Neck Surgery E-Book: Head and Neck Surgery, 3-Volume Set. Elsevier Health Sciences; 2010.
Niculescu B, Vesa D, Tomescu E. Variations of Pre-and Post-Operative Hearing Loss Depending On The Size Of Tympanic Membrane Perforation. Medical Interven. 2011;1(3):236-241.
Shetty S. Pre-Operative and Post-Operative Assessment of Hearing following Tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2012;64(4):377-381. doi: https://doi.org/10.1007/s12070-011-0331-6.
Onal K, Uguz MZ, Kazikdas KC, Gursoy ST, Gokce H. A multivariate analysis of otological, surgical and patient-related factors in determining success in myringoplasty. Clin Otolaryngol. 2005;30(2):115-120. doi: https://doi.org/10.1111/j.1365-2273.2004.00947.x
Angeli SI, Kulak JL, Guzmán J. Lateral tympanoplasty for total or near-total perforation: prognostic factors. Laryngosco. 2006;116 (9): 1594-1599. doi: https://doi.org/10.1097/01.mlg.0000232495.77308.46.
Umar AS, Ahmed Z. Anatomical and Functional Outcome Following Type1 Tympanoplasty in Chronic Tubotympanic Suppurative Otitis Media. Pak Armed Forces Med J. 2008;58(1):62-67.
Batni G, Goyal R. Hearing Outcome After Type I Tympanoplasty: A Retrospective Study Indian J Otolaryngol Head Neck Surg 2015;67(1):39–42. doi: https://doi.org/10.1001/archotol.125.5.530.
Smyth GD. Toynbee Memorial Lecture 1992: facts and fantasies in modern otology: the ear doctor's dilemma. J Laryngol Otol. 1992;106(7):591-596. doi: https://doi.org/10.1017/S0022215100120274.
Wielgosz R, Mroczkowski E. Assessment of the hearing results in tympanoplasties with the use of palisade-technique. Otolaryngologia polska= The Polish Otolaryngol. 2006;60(6):901-905.
Gerber MJ, Mason JC, Lambert PR. Hearing results after primary cartilage tympanoplasty. Laryngoscope. 2000; 110(12):1994-1999. doi: https://doi.org/10.1097/00005537-200012000-00002.
Gierek T, Slaska-Kaspera A, Majzel K, Klimczak-Gołab L. [Results of myringoplasty and type I tympanoplasty with the use of fascia, cartilage and perichondrium grafts]. Otolaryngol Pol. 2004;58(3): 529-533.
Effat KG. Results of inlay cartilage myringoplasty in terms of closure of central tympanic membrane perforations. J Laryngol Otol. 2005;119(8):611-613. doi: https://doi.org/10.1258/0022215054516188.
Emir H, Ceylan K, Kizilkaya Z, Gocmen H, Uzunkulaoglu H, Samim E. Success is a matter of experience: type 1 tympanoplasty : influencing factors on type 1 tympanoplasty. Eur Arch Otorhinolaryngol. 2007;264(6):595-599. doi: https://doi.org/10.1007/s00405-006-0240-6
Copyright (c) 2019 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.