TO COMPARE THE STUDY OF THE EFFECTIVENESS OF THE USE OF TRAGAL CARTILAGE WITH TEMPORALIS FASCIA IN TYMPANOPLASTY

Dr. Abhimanyu Sangwan; Dr. Sandip M Parmar; Dr. Abhey Sood

Volume : VII, Issue : II, February - 2018

TO COMPARE THE STUDY OF THE EFFECTIVENESS OF THE USE OF TRAGAL CARTILAGE WITH TEMPORALIS FASCIA IN TYMPANOPLASTY

Dr. Abhimanyu Sangwan, Dr. Sandip M Parmar, Dr. Abhey Sood

Abstract :

Background: He� is a sense that enables man to establish contact with his fellows via speech to experience life more fully. Deafness in varying degrees of severity is a big impediment to the integration of a person into the social structure. The otologist in the past had not much to offer to he� handicapped people with chronic middle ear disease. With recent times the advent of the antibiotic era, the operating microscope and modern anesthetics techniques aimed at producing a dry, magnified operating field, have radically altered the outlook.

Methods: This Prospective Randomised Comparative Study comprises of patients who were subjected to tympanoplasty for the treatment of chronic suppurative otits media. Each patient was subjected to a detail examination of nose, paranasal sinuses and throat to rule out any focus of infection, which could influence the result of tympanoplasty. 35 Patients were subjected to tympanoplasty with temporalis fascia while the remaining 35 patients underwent with tragal perichondrium in the age group of 15–50 years (males and females both ). Patients with the complaint of discharging ear and decreased he� were also screened .

Results: Majority of the patients preoperatively showed mild to moderate he� loss.45.7% patients showed upto 20 db air bone gap range, 48.5% patients being in 21–40db air–bone gap and only 5.7% patients is above 40db. Graft take rate was overall 78.5%. Take–rate was 80% with temporalis fascia and 77.1% with tragal perichondrium. In the postoperative he� analysis, 75.7% of the patients showed air– bone gap upto 20dB. 21.4% of the patients showed air– bone gap in the range of 21–40 Db. Mean improvement in he� for temporalis fascia was 12.8 db and for tragal perichondrium was 11.4 db. Take rate of graft was not influenced by the size of perforation. Improvement in he� was also not significantly influenced by the type of graft used.

Conclusion: Tympanoplasty is the most effective method for control of the tubotympanic type of CSOM disease and he� improvement. Both temporalis fascia and tragal perichondrium are excellent graft materials for closure of perforation of tympanic memane and he� improvement. Graft uptake rate is good for both with slightly better take rates for temporalis fascia, than tragal perichondrium.Improvement in he� is not significantly influenced by duration of disease, age or sex of patients site or size of perforation