Does cartilage Tympanoplasty give better results than Tympanoplasty using temporalis fascia graft in paediatric Tympanoplasty with respect to graft uptake and hearing improvement

Dr Shahnaz Sheikh; Dr Manzoor Ahmad Malik; Dr Anushree Bajaj; Dr Balchandra Paike

Volume : VII, Issue : IX, September - 2018

Does cartilage Tympanoplasty give better results than Tympanoplasty using temporalis fascia graft in paediatric Tympanoplasty with respect to graft uptake and hearing improvement

Dr Shahnaz Sheikh, Dr Manzoor Ahmad Malik, Dr Anushree Bajaj, Dr Balchandra Paike

Abstract :

Aims: The aim of my study is to comparecartilageTympanoplasty with Tympanoplasty using temporalis fascia graft in pediatric tympanoplasty with respect to graft uptake and he� improvement.

Material and methods: This study was conducted in ENT department DUPMC and hospital between 2017 to 2018. All patients were in the age group 9–13 years having chronic suppurative otitis media with perforation in the pars tensa. The patients for the study were selected on the basis of inclusion and exclusion criteria. All patients underwent tympanoplasty type I under general anesthesia via postauricular approach. Patients were divided into Group A i.e. with Tympanoplasty using tragal cartilage island graft and GroupBi.e.withTympanoplasty using temporalis fascia graft .there were 40 patients in each group. Data regarding successful perforation closure and he� improvement were recorded and final assessment made at 6 months.

Results: The overall perforation closure was 85.55%. In cartilage island group it was 93% and in temporalis fascia group 80.5%. Residual perforation was seen in 8 cases, 2 in cartilage island group and 6 in temporalis fascia group. Regarding age, children 9–11 years had better outcome concerning anatomical success with cartilage island graft than temporalis fascia graft with statistical significance (p=0.03). Although better anatomical results were observed in 11–13 years with cartilage island graft than temporalis group, but we did not find any statistical significance. Audiological improvement was 10.5 dB. The mean AB gap gain in the cartilage island group was 10.0dB and in the temporalis fascia group it was 13.2 dB. There was no difference between the audiologicoutcome after paediatrictympanoplasty in both groups.

Conclusion: In my study cartilage and temporalis fascia graft provides good anatomical and audiological results in children. Cartilage tympanoplasty in pediatric age group (9–11 years) has an additional advantage of improvement in long term closure of the tympanic memane in comparison to temporalis fascia graft.