TYPE 1 TYMPANOPLASTY–5 GOLDEN RULES FOR 100% SUCCESS IN TERMS OF GRAFT UPTAKE AND HEARING IMPROVEMENT.

Dr K V S Kumar Chowdary; Dr N Srikanth; Dr Sk Feroz Basha

Volume : VI, Issue : V, May - 2016

TYPE 1 TYMPANOPLASTY–5 GOLDEN RULES FOR 100% SUCCESS IN TERMS OF GRAFT UPTAKE AND HEARING IMPROVEMENT.

Dr K V S Kumar Chowdary, Dr N Srikanth, Dr Sk Feroz Basha

Abstract :

Aim: The purpose of this study is to propose concepts for 100% success rate in graft uptake and heå improvement. Materials and Methods: This is a clinical retrospective study of 1050 patients of chronic suppurative otitis media over a period of nine years. Surgical management of Chronic Suppurative Otitis Media has undergone lot of changes and recent developments. The management of dry central perforation is by Type I Tympanoplasty. The 5 Golden rules for 100% success rate in Type I Tympanoplasty are • Post auricular incision. • Temporalis fascia. • Underlay grafting. • Exteriorization of handle of malleus. • Anterior window. Results: Temporalis fascia has been accepted as an universal graft material after discarding lot of others. Underlay grafting, Exteriorization of handle of malleus and anterior window creation in all cases of Type I Tympanolasty over the last nine years of our experience in 1050 cases of dry central perforation have lead to 98% in terms of graft uptake and near normal levels of heå in terms of heå improvement. No differences in success rates were observed due to changes in size and site of perforation when these steps were followed in all cases. Conclusion: Harvesting temporalis fascia by postauricular incision and doing the entire procedure postauricularly with placement of temporalis fascia all over the bony sulcus under the annulus with underlay grafting and exteriorization of handle of malleus and supporting it with gel foam in middle ear along with stabilization of the graft anteriorly by pulling it through the anterior window optimizes the results and prevents failures.