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Background:Chronicsuppurative otitis media tubotympanic type is a common pathology for which tympanoplasty is done. The decision to decide the approach for tympanoplasty de pends upon multiple factors like extent of disease, site and size of perforation, size of external auditory canal and surgeon’s own expertise and preference. This study was undertaken to compare endoscopic and microscopic approach for type-1 tympanoplasty.Material And Methods:This study data was collected from 50 patients who underwent tympanoplasty in our department in our hospital from July –2017 to November 2019.Patients above 15 years of age with inactive chronic otitis media tubotympanic type operated for type-1 tympanoplasty. Pre-operative, intra-operative and post-operative data collected as per performa and evaluated.Result:Equal (25) number of cases underwent microscopic and endoscopic type-1 tympanolasty. As far as graft taken up is concern both approaches have good and comparable result. Hearing gain is almost similar in both approaches -Endoscopic approach-10.80 dB; microscopic approach-11.23 dB.Both methods do not have any major complications. Endoscopic approach has advantage of depth and angled vision. Endoscopic approach (57.2 min.) also saves surgical time than microscopic approach (89.4 min.) and comparatively good cosmetic result. Microscopic approach has upper hand over endoscopic appr oach in having two hande d surgery with magnified surgical view. Patient compliance and satisfaction is more with endoscopic approach.Conclusion:Both microscopic and endoscopic methods are excellent for type-1 tympanoplasty with advantage and limitation of each method. A careful selection of patient is necessary for endoscopic approach.
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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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BACKGROUND AND OBJECTIVES: The objective of this study was to evaluate improvement in hearing and changes in the tympanogram according to the types of mastoid pneumatization and the mucosal condition of the Eustachian tube orifice after performing tympanoplasty type 1. MATERIALS AND METHODS: Among the patients with chronic otitis media who had received tympanoplasty type 1 at Asan Medical Center from June 1990 to March 1997, sixty five patients were evaluated with pure tone audiometry and tympanometry for a short-term (1 year) follow-up period. RESULTS: Greater improvement in hearing was shown in patients with tympanogram type A as compared to the patients with type B and C in both short-term and long-term follow-ups. Patients who showed normal mastoid pneumatization were found to have type A tympanogram more frequently than patients who showed abnormal mastoid pneumatization. However, the degree of postoperative hearing improvement did not depend on the types of mastoid pneumatization. Mucosal condition of the Eustachian tube orifice had some influence on the outcome of postoperative tympanogram and hearing. Greater improvement in the hearing levels were observed more frequently in the normal mucosa. CONCLUSION: Postoperative improvement in hearing was closely related to the postoperative change in the tympanogram. Postoperative hearing results and tympanograms were mainly influenced by the mucosal condition of the Eustachian tube orifice. Relatively greater improvement in hearing was observed in the long-term follow-up compared to the short-term follow-up. However, in order to reach any conclusion on this matter, a longer follow-up period and closer observation would be required.