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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
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OBJECTIVE: To compared the outcome of Type 1 tympanoplasty with cartilage-perichondrium graft in comparison with temporalisfascia graft in terms of post-operative graft take-up and hearing results.MATERIALS AND METHODS: A prospective observational study among 80 patients between 15 and 60 years of age satisfyingthe inclusion criteria with complaints of ear discharge and hearing loss due to COM - mucosal type was conducted. Patientswere grouped in two groups of 40 patients each. Group A patients underwent Type 1 tympanoplasty with temporalis fasciaand Group B with cartilage-perichondrium graft. Patients were followed up for graft uptake, hearing improvement and rate offailure are compared for both the grafts. Graft uptake was assessed at the end of the 1st month, 3rd month, and 6th month,and hearing was assessed at the end of the 6th month with pure tone audiometry.RESULTS: Patients with temporalis fascia graft showed a take-up rate of 80% and cartilage-perichondrium graft of 92.5% by6 months. Among the fascia group, graft failure was seen in 20% (8). One patient had failed take-up of graft and four patientsshowed reperforation. In cartilage group, three patients showed failure of take-up of graft during the 1st month. No patient hadreperforation or retraction. Air-bone gap in fascia group showed a closure to 10 dB in 17.5% (7). In the cartilage group, 10 dBin 25% (10 patient s). In our short-term follow-up of 6 months, we found that cartilage-perichondrial graft reduces the chanceof reperforation and retraction even with variation in middle ear pressure due to eustachian tube catarrh. It gives good takeup rate and comparable hearing result as that of the fascia graft. It does not affect the sound conduction when thinned outto appropriate thickness. It is available from the same surgical field and in sufficient quantity for the closure of the TM defect.Cartilage-perichondrium graft for Type 1 tympanoplasty could be a successful replacement for temporalis fascia giving goodresult with neotympanum.
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Subject(s)
Female , Humans , Young Adult , Epistaxis , Fascia , Nasal Septal Perforation , Nasal Septum , Nose , Singing , TransplantsABSTRACT
Abstract Introduction: Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane. Objective: To describe and evaluate the modified sandwich graft (mediolateral graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty. Methods: A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay technique. We assessed the healing and hearing results. Results: Successful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4 ± 1.7 dB while in Group B; it was 22.5 ± 3.5 dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant. Conclusion: Double layered graft with drum-malleus as a 'meat' of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity.
Resumo Introdução: O reparo cirúrgico da membrana timpânica, denominado timpanoplastia tipo 1, é uma modalidade de tratamento já bem estabelecida. As técnicas overlay ou underlay de timpanoplastia são comuns. A timpanoplastia "sanduíche" é a técnica de enxerto de membrana timpânica overlay e underlay combinadas. Objetivo: Descrever e avaliar a timpanoplastia com a técnica "sanduíche" modificada (timpanoplastia mediolateral) utilizando fáscia temporal e fáscia aureolar. Comparar o desfecho clínico e audiológico da timpanoplastia com a técnica "sanduíche" modificada com o da timpanoplastia com a técnica underlay. Método: Foram estudados 88 pacientes com otite média crônica, 48 (Grupo A) foram submetidos à timpanoplastia tipo 1 com enxerto "sanduíche" modificado. A fáscia temporal foi utilizada na técnica underlay e a fáscia areolar na técnica overlay. 48 pacientes (Grupo B) foram submetidos à timpanoplastia tipo 1 com a técnica underlay. Foram avaliados os resultados da cicatrização e da audição. Resultados: O sucesso do enxerto ocorreu em 47 pacientes (97,9%) no Grupo A e em 40 (83,3%) do Grupo B. O fechamento médio do gap aéreo-ósseo no Grupo A foi de 24,4 ± 1,7 dB, enquanto no Grupo B foi de 22,5 ± 3,5 dB. Houve diferença estatisticamente significativa na taxa de cicatrização do enxerto. A diferença na melhora auditiva não foi estatisticamente significante. Conclusão: O enxerto de camada dupla e o tímpano-martelo posicionados como o "recheio" do sanduíche mantém um equilíbrio perfeito entre a estabilidade necessária e adequada sensibilidade acústica.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Otitis Media/complications , Tympanoplasty/methods , Tympanic Membrane Perforation/surgery , Fascia/transplantation , Hearing Loss/surgery , Audiometry, Pure-Tone , Chronic Disease , Prospective Studies , Treatment Outcome , Tympanic Membrane Perforation/etiology , Recovery of Function , Hearing Loss/rehabilitationABSTRACT
Background: Hearing 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 hearing 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 hearing were also screened . Results: Majority of the patients preoperatively showed mild to moderate hearing 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 hearing 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 hearing 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 hearing 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 hearing improvement. Both temporalis fascia and tragal perichondrium are excellent graft materials for closure of perforation of tympanic membrane and hearing improvement. Graft uptake rate is good for both with slightly better take rates for temporalis fascia, than tragal perichondrium.Improvement in hearing is not significantly influenced by duration of disease, age or sex of patients site or size of perforation
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Background: Chronic Suppurative Otitis Media (CSOM) is one of the most common causes of preventable hearing loss especially in developing countries CSOM is a disease condition characterized by persistent perforation of tympanic membrane with recurrent or persistent mucopurulent Otorrhoea Aim: This study was undertaken to review the outcomes (hearing improvement) achieved by using various graft materials like temporalis fascia (TF), tragal cartilage (TC), Conchal cartilage (CC), autologous sculpted incus (I), autologous cortical bone (BG) in tympanoplasty surgery Material and methods: This study comprised of 14 males and 16 females patients with age ranging from 12 years to 55 years They were selected for surgery after adequate history taking, clinical, otoscopic and microscopic examination Type 1 tympanoplasty was done in 19 patients, Type 3 tympanoplasty + Modified Radical Mastoidectomy (MRM) was done in 11 patients by using various graft materials The results were evaluated in the form of rate of graft success, hearing gain, and the pre and post-operative Air Bone gap Results: Out of 30 patients, in 20 TF graft patients AB gap improvement seen in 14 patients, 5 patients did not show any change and 1 patient did not come for follow up In 2 TC graft patients, both showed improvement in AB gap In 1 patient where CC graft was used showed improvement in AB gap In 6 patients I graft was used, 2 patients showed improvement, 2 patients did not show any change, 1 patient did not come for follow up and in 1 patient AB gap worsened In 1 patient BG was used and no change in AB gap was seen Out of 30 cases graft uptake was seen in 25 cases and graft rejection was seen in 3 cases and 2 patients did not come for follow up Graft rejection was documented in one case where TF was used, one case where incus graft was used and in another case where BG was used Harinarayana N, Srikanth M A study on the outcome of tympanoplasty with various graft materials IAIM, 2018; 5(12): 77- 82 Page 78 Conclusion: Post-operative hearing gain obtained was found to be better in patients operated upon with tubotympanic disease than those operated upon with atticoantral disease The post-operative hearing improvement depends not only on the graft material used and the type of tympanoplasty but also on the pre-operative status of the ossicular chain
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OBJECTIVE To investigate the clinical curative effect of acellular dermal matrix contrast with temporalis fascia in type Ⅰ tympanoplasty. METHODS A retrospective analysis of 60 inflammatory chronic suppurative otitis media patients from January 2014 to January 2015 in Genenral Hospital of PLA Guangzhou Military Area were conducted.All cases were perpormed the ear incision under local anesthesia, including 32 cases(32 ears) with acellular dermal matrix, 28 cases(28 ears) with temporal fascia. The operation time, postoperative pain, the healing of tympanic membrane and the postoperative recovery were compared between the two groups. RESULTS There was significant difference in the operation time and postoperative pain between the two groups(P0.05). CONCLUSION The effect of acellular dermal matrix for repairing tympanic membrane is similar to the temporalis fascia. The use of acellular dermal matrix has the advantage of shorter operation time, less postoperative pain, and can avoid regional two incisions, it is worthy of clinical application.
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Aim: To compare the result of graft materials i.e. temporalis fascia, tragal perichondrium and ear lobule fat in various aspects but the prime interest would be the closure of tympanic membrane perforation and postoperative hearing improvement. Materials and methods: The study was carried out on 60 patients admitted for myringoplasty as per selection criteria in the Department of Ear Nose and Throat for a period of 1 year in patients autogenous graft materials was used and they were divided into three groups. In Group A 20 patients in which termporalis fascia was used as graft, Group B 20 patients in which tragal perichondrium was used as graft and Group C 20 patients in which ear lobule fat was used as graft. Results: Maximum number of patients (41.7%) was in the age group of 21-30 years. Female patients outnumber the male patients. The male female ratio was 1: 2. Rural population was more as compared to urban in study groups. Left ear was more involved in all the groups. Maximum number of patients i.e. in group A (50%), in group B (45%) and in group C (55%) was having duration of ear discharge of 1-5 years. Dry ear of <3 months of duration in group A, group B and group C was 50%, 80%, and 70% of patients respectively. In group A, 50% of patients had more than 30dB AB gap while 45% of group B and 50% of group C had less than 20dB AB gap. Overall total AB gap was 10.33 ± 9.62 dB. Mean improvement in hearing was 12.32 ± 8.42 dB, 10.38 ± 5.73 dB and 12.62 ± 8.06 dB in group A B and C respectively. Conclusion: Temporalis fascia graft has good improvement of hearing when compared to other grafts in study. Ear lobule fat when used in small perforations has encouraging results.
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The perforations of the tympanic membrane may be of traumatic origin or due to chronic suppurative otitis media. If the perforations fail to heal conservatively, they require surgical closure. Autologous graft materials have stood the test of time in repairing tympanic membrane perforations. In our tertiary care institution, we conducted a prospective randomised control trial on 20 subjects to evaluate the comparative efficacy of temporalis fascia and tragal perichondrium as grafting material in underlay tympanoplasty. In this study, surgical success was evaluated in terms of intact drum membrane and minimal complications during the follow-up period. Temporalis fascia achieved a graft uptake of 90% and a satisfactory hearing improvement in 76% of the patients with minimal postoperative complications. Tragal perichondrium achieved a success rate of 80% graft uptake and 75% hearing gain. The rates are comparable with no statistical significance of difference between them.
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The definite cause of temporomandibular joint (TMJ) ankylosis is still an unknown fact. TMJ ankylosis may result from, infection, trauma or insufficient surgical treatment of the mandibular condyle region. Different techniques have been described so far for the treatment of TMJ ankylosis, but no technique has successfully given uniform results. Relapse causing limited mouth opening, infection, open bite, reankylosis are the complications. Many authors agree that aggressive physiotherapy immediately after the surgical procedure, interpositional graft as spacer and wide bone resection are the basic principles in treating TMJ ankylosis. In this article, we discussed a case of unilateral TMJ ankylosis, in a 9-year-old boy, treated with the intre-positional gap arthroplasty with superficial temporalis fascia flap.
Subject(s)
Ankylosis/diagnosis , Ankylosis/surgery , Child , Fascia/transplantation , Humans , Male , Plastic Surgery Procedures/methods , Surgical Flaps , Temporal Muscle/transplantation , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Disorders/surgeryABSTRACT
Management of facial paralysis varies according to the cause, the extent and type of paralysis (total vs partial, unilateral vs bilateral) as well as the duration of paralysis. Facial nerve reconstruction including restitution of the facial symmetry and facial expression is a great surgical challenge. Considering the often disappointing results achieved with the currently available techniques, a continued search for alternative donor sites seemed appropriate. Numerous techniques for facial reanimation have been developed over time, with the ultimate goal being the restoration of both function and form. A case of post traumatic facial nerve palsy managed by reanimation with temporalis muscle lengthened by temporalis fascia is discussed.
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El sulcus vocalis es una lesión en la cual el epitelio del pliegue vocal tiende a invaginarse y adherirse al ligamento y/o músculo resultando en disfonía. Existen múltiples tratamientos descritos ninguno con resultados ideales. Este es un estudio descriptivo-prospectivo en el Hospital Militar Central en pacientes operados por sulcus vocalis tipos II y III e implantados con fascia autóloga entre junio de 2006 y diciembre de 2008. De 17 pacientes operados cumplieron los criterios de inclusión 11. Edad promedio 32 años. 9 presentaron mejoría del análisis acústico de la voz con una tendencia a la mejoría en todas las variables, particularmente en el Shimmer y la frecuencia fundamental. En la estroboscopia, 10 pacientes presentaron recuperación de la onda mucosa y en 5 del cierre glótico. Ningún paciente presentó reacciones adversas al procedimiento. Del presente estudio se puede considerar que el manejo del sulcus vocalis con injerto autólogo de fascia temporal es un procedimiento seguro que en la mayoría de los casos representa una mejoría subjetiva y objetiva de la calidad de voz. Es necesario aumentar el tamaño de la muestra para obtener resultados de mayor poder estadístico y definir los criterios de éxito.
Sulcus vocalis is an injury in which the epithelium of the vocal fold tends to invaginate and attach to the ligament and / or muscle resulting in dysphonia. There are multiple treatments as described but none has ideal results. This is a descriptive prospective study carried out at the Hospital Militar Central in patients that had been operated on due to sulcus vocalis of the type II and III and who have been given implants with autologous fascia between June, 2006 and December, 2008. Out of 17 patients that were operated on, 11 complied with the inclusion criteria. The average age was 32 years old. 9 of them exhibited an improvement on the acoustic analysis of the voice with a tendency to improvement in all variables, especially in Shimmer and the basic frequency. 10 patients exhibited a recovery of the mucous wave in the stroboscope analysis and 5 in the glottal closure. Not one patient showed adverse reactions to the procedure. It can be considered from this study that managing sulcus vocalis with a temporalis fascia autologous graft is a safe procedure that represents a subjective and an objective improvement of the quality of the voice. It is necessary to increase the size of the simple in order to obtain results with a greater statistical power and be able to define the criteria for success.
Subject(s)
Fascia/anatomy & histology , Fascia/abnormalities , Fascia/physiologyABSTRACT
BACKGROUND AND OBJECTIVES: Many materials such as fascia, perichondrium and cartilage are used for reconstruction of the tympanic membrane in middle ear surgery. Because of its stiffness, cartilage is resistant to resorption and retraction. However, cartilage grafts result in increased acoustic impedance, so its use has caused controversies as to the acoustic transfer aspect. The aim of this study is to assess hearing results after cartilage tympanoplasty and after fascia tympanoplasty. SUBJECTS AND METHOD: This study included 74 patients who had received tympanoplasty type I between 2007 and 2009, of whom 44 received cartilage and 30 fascia. The middle ear risk index was used to statistically compare the preoperative state of the two groups. Preoperative and six months- postoperative air-bone gaps at the frequency 0.5, 1, 2 and 3 kHz were assessed. RESULTS: Both groups were statistically similar with respect to the severity of middle ear pathology and the preoperative hearing levels. Overall postoperative hearing results showed air-bone gaps (ABG) < or =20 dB in 73% for the fascia group and 71% for the cartilage group. The mean postoperative gains in ABG were 8.97 dB for the fascia group and 10.84 dB for the cartilage group. There were no statistically significant differences in the postoperative frequency specific gains in ABG between the two groups. CONCLUSION: These results demonstrate that hearing results after cartilage tympanoplasty are comparable to those after fascia tympanoplasty. Although cartilage is the ideal grafting material in problem cases, a more liberal application might be suggested in such cases as in tympanoplasty type I without fear of impairing hearing.
Subject(s)
Humans , Acoustics , Cartilage , Ear, Middle , Electric Impedance , Fascia , Hearing , Transplants , Tympanic Membrane , TympanoplastyABSTRACT
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Humans , Male , Congenital Abnormalities , Fascia , Follow-Up Studies , Malocclusion , Nose , Orthognathic Surgery , Rhinoplasty , Tissue Donors , TransplantsABSTRACT
PURPOSE: To evaluate the result and complications of autogenous temporalis fascia grafting and conjunctival flap transposition as a treatment of scleromalacia after pterygium excision. METHODS: We used autogenous temporalis fascia and conjunctival flap to treat scleromalacia of 9 patients(9 eyes) who underwent pterygium excision and checked the postoperative result and complications. RESULTS: We could keep the temporalis fascia graft without necrosis during follow-up examination. Pain, inflammation and scleral discoloration were disappeared after temporalis fascia grafting in all cases. Postoperative complications were included 2 cases of progression of cataract and 1 case of mild chamber inflammation. CONCLUSIONS: We obtained good surgical result of scleromalacia after pterygium excision by autogenous temporalis fascia grafting with conjunctival flap transposition.
Subject(s)
Cataract , Fascia , Follow-Up Studies , Inflammation , Necrosis , Postoperative Complications , Pterygium , TransplantsABSTRACT
We utilized a clip-reinforced wrapping technique using temporalis fascia for treating unclippable aneurysms in 14 patients. Herein, we describe a modification of the clip- reinforced wrapping technique and report on the results. An appropriately sized strip of temporalis fascia is passed around the aneurysms with cuts made to accommodate perforating arteries. After applying fibrin glue, the aneurysm clip is positioned to secure the circumferential wrapping. Of the 14 patients, 4 (29%) were unclippable microbleb, 4 (29%) were wall defect, 3 (21%) were imperfect clipping due to the complexity of the aneurysm, 2 (14%) were bleb at the base of the aneurysm and 1 (7%) was a fusiform aneurysm. Multiple aneurysms were found in 6 (43%) patients and half (50%) of the 14 patients had MCA aneurysms. Postoperative angiography demonstrated no narrowing of parent arteries or enlargement of the aneurysms. No subsequent bleeding was observed during the 1 year follow-up period. These results suggest that circumferential wrapping-clipping with temporalis fascia and biological glue provides an alternative and safe method of treatment for unclippable intracranial aneurysms.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Intracranial Aneurysm/surgery , Neurosurgical Procedures/methodsABSTRACT
PURPOSE: A wide variety of surgical materials have been used for blepharoptosis such as catgut, silicone, 4-0 nylon polyfilament cable-type ophthalmic suture (Supramid(R)), autogenous tendon (palmaris longus),banked sclera, dura mater, fascia lata, and temporalis fascia. The aim of this study was to evaluate the effect of frontalis suspensory surgery with temporalis fascia. METHODS: The authors studied 91 frontalis slings (71 patients) performed from 1993 to 1999 at our hospital for repair of blepharoptosis. Results with temporalis fascia (group A) as the suspensory material were compared to those with autogenous (group B) and preserved (group C) fascia lata. RESULTS: The success rates of group A (31 lids 21 patients), group B (28 lids 24 patients), group C (32lids 26 patients) were 80.6%, 75%, 78.1% respectively. But there was no statistically significant difference in each groups (P>0.05). CONCLUSIONS: We concluded that temporalis fascia for frontalis sling could be used as suspensory material successfully. Moreover, long term and further evaluations must be considered.
Subject(s)
Blepharoptosis , Catgut , Dura Mater , Fascia Lata , Fascia , Nylons , Sclera , Silicones , Sutures , TendonsABSTRACT
Hydroxyapatite recently has been used for its excellent results compared with other implant materials, but the tissue breakdown and exposure of the hydroxyapatite implant was reported due to hemorrhage or infection. Five patients with exposed hydroxyapatite implant after evisceration or enucleation were studied.The hydroxyapatite implant exposure occurred in 2 to 8 weeks (mean 4.2 weeks)after implantation.Conjunctival defects with various sizes were noted in all cases and purulent discharge in one case. An autogenous temporalis fascia patch graft was placed instead of preserved sclera or fascia lata for the intensification of the defect area.No reexposure occurred during a follow-up examination and we could keep the implant well in all cases. The temporalis fascia is advantageous over preserved sclera or fascia lata because it is firm and can be easily obtained from the same operative field as the primary surgery.Therefore, it is thought to be suitable for graft material in surgery of the exposed hydroxyapatite.No scars are visible after obtaining temporalis fascia.
Subject(s)
Humans , Cicatrix , Durapatite , Fascia Lata , Fascia , Follow-Up Studies , Hemorrhage , Sclera , TransplantsABSTRACT
Mitomycin C is now being used not only as an adjunct in the surgical treatment of pterygia but also in glaucoma surgery. However, several serious complications that are possibly related to mitomycin C treatment have been reported. We report on a series of 8 patients(10 eyes) who experienced scleral ulcer after pterygium excision. The period from operation to onset of scleral ulcer was between 5 months and 20 years. Complications included corneoscleral perf oration(1 eye), scleral ulceration(9 eyes), corneal ulceration(2 eyes), complicated cataract(5 eyes) and uveitis(4 eyes). We used autogenous temporalis fascia to reinforce the weakened lesion of 10 eyes with scleral or corneoscleral ulceration. Three eyes underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation after stable grafting. Grafts remained stable in 9 eyes over a mean follow-up of 10.8 +/- 10.4 months(3 to 37 months). One graft melted but regrafting salvaged the eye. Six of 10 eyes improved vision. All patients resolved their subjective symptoms after temporalis fascia grafting. We found autogenous temporalis fascia grafting is efficacious in both treating and preventing ocular perforation due to progressively destructive scleral ulceration.
Subject(s)
Humans , Cataract Extraction , Fascia , Follow-Up Studies , Glaucoma , Lens Implantation, Intraocular , Mitomycin , Pterygium , Transplants , UlcerABSTRACT
We performed scleral grafting with autogenous temporalis fascia and autogenous conjunctiva in 32 patients (32 eyes) in scleral necrosis after pterygium excision. The average age of patients was 54.3 years (range, 38 to 74 years). Nine of them were male and twenty-three were female. The intervals between pterygium excision and scleral necrosis were from 2 months to 23 years (mean, 6.2 years). After the mean follow-up 6.6 months, in 29 eyes graft was stably adhered but in three eyes graft was melted. Conjunctival wound dehiscence and conjunctival necrosis were noticed in three eyes and one eye respectively. There were no cases showing significant difference between the preoperative and the postoperative visual acuity and intraocular pressure. Autogenous temporalis fascia appears to be a good alternative to homologous sclera for scleral reinforcement.