KUMJ | VOL. 20 | NO. 3 | ISSUE 79 | JULY-SEPT. 2022
Comparison of Hearing Result and Graft Uptake Rate between Temporalis Fascia and Tragal Cartilage in Endoscopic Myringoplasty
Shrestha BL, Shakya S, Pradhan A, Dhakal A, KC AK, Shrestha KS, Pokharel M
Abstract: Background
There are different methods to repair the perforation of the tympanic membrane.
Recently cartilage has been used for the repair and results are comparable to
temporalis fascia. For surgical procedure endoscope had added good assistance in
middle ear surgery. Though the one hand technique the image quality and results are
on par with the use of a microscope.
Objective
To compare the graft uptake rate and hearing results between temporalis fascia and
tragal cartilage in endoscopic myringoplasty.
Method
This is a prospective, longitudinal study conducted among 50 patients who
underwent endoscopic myringoplasty using temporalis fascia and tragal cartilage
with 25 patients in each group. The hearing was assessed by comparing pre with
post-operative ABG (Air bone gap) and ABG closure in speech frequencies (500Hz, 1
KHz, 2 KHz, 4 KHz). The status of graft and hearing results was evaluated on 6 months
of follow up in both the groups.
Result
Out of total 25 patients enrolled for study in both (temporalis fascia and cartilage)
groups, 23 (92%) patients in each group had graft uptaken. The audiological gain in
the temporalis fascia group was 11.37±0.32 dB whereas in the tragal cartilage group
it was 14.56±1.22dB. The audiological gain between the two groups did not show
any statistically significant (p = 0.765). However, the pre and post-operative hearing
difference was statistically significant in both temporalis fascia and tragal cartilage
group.
Conclusion
Tragal cartilage has similar graft uptake rate and hearing gain when compared with
temporalis fascia in endoscopic myringoplasty. Hence, tragal cartilage can be used
for myringoplasty whenever required without any fear of deterioration in hearing.
Keyword : Air bone gap, Endoscopic myringoplasty, Temporalis fascia, Tragal cartilage
