ABSTRACT
Introduction: Type 1 tympanoplasty is one of the commonest operations done by an ENT surgeon. There are a number of choices regarding the graft material that one uses in this operation. Among those, temporalis fascia and tragal perichondrium are the most common. The aim of the study was to compare the results of tympanoplasty between two groups of patients- one using temporalis fascia as the graft material and the other using tragal perichondrium. Material and methods: This prospective study group consisted of 46 patients between the ages of 10 to 49 years. Only patients with dry safe central perforations and pure conductive hearing loss were included. Success was defined as ear-drum closure with no residual perforation. Hearing improvement was defined as air-bone gap less than 10dB. Results: We had included 46 patients in our study. Of them, 23 had tympanoplasty with temporalis fascia and the other 23 had tympanoplasty with tragal perichondrium. Conclusion: The study showed that both temporalis fascia and tragal perichondrium gave more or less the same results with regard to successful drum closure and hearing improvementthere was little to choose between these two
ABSTRACT
OBJECTIVES: The classical overlay tympanoplasty is technically difficult with some disadvantages and thus less popular. However, it is particularly useful for large, anterior perforations. In this study, we describe the technique of a modified overlay graft in the tympanoplasty coined as the swing-door overlay tympanoplasty and report its outcomes. METHODS: Retrospective review of patients undergoing the swing-door overlay tympanoplasty at a tertiary referral center between 2003 and 2016 was performed. Patient who had ossicular abnormality, previous tympanoplasty, and profound hearing loss were excluded. The surgical technique is described in detail. The outcomes were evaluated by the graft success rate, complication rate, and hearing results. The hearing level was determined by four pure-tone average at 0.5, 1, 2, and 4 kHz. Air-bone gap closure was mainly assessed. RESULTS: A total of 306 patients (110 males and 196 females) were included. The mean age was 49.1±16.6 years. Follow-up periods ranged from 6 to 108 months with an average of 18.4 months. The overall graft success rate reached 98.4%. Five graft failures occurred with reperforation in three cases and lateralization in two cases. Postoperative complications occurred in 12 cases (3.9%). Air-bone gap changes (closures) were 7.8±12.8, 5.2±12.2, 5.7±10.2, and 6.0± 12.8 dB at 0.5, 1, 2, and 4 kHz, respectively (all P < 0.001) with an average improvement of 6.2 dB. Postoperative airbone gap was closed to ≤20 dB in 86.9%. CONCLUSION: The swing-door overlay tympanoplasty is a highly successful surgical technique suitable for all types of tympanic membrane perforations. This approach is technically easier than classical overlay tympanoplasty and affords an excellent graft success rate with satisfying hearing results.