呼吸器医学ジャーナル

Temporalis fascia Vs Tragal cartrilge Myringoplasty outcomes (Graft uptake and Hearing improvement)

Said Mustafa 

Background: Hearing is the sense which enables us to perform contact with our fellows via speech to experience life more fully. Deafness in different degrees of severity is a huge impediment to the integration of a man into the social structure. Previously, the otologist had not much to offer to people with hearing impairment due to damaged tympanic membrane. Now a day the advent of myringoplasty can offer repairing the damaged tympanic membrane and hearing restoration by using a variety of graft materials. Objective: To compare and to evaluate the graft uptake and hearing out comes after myringoplasty using temporalis fascia graft and tragal cartilage graft. Methods: This prospective non-randomized study comprises of forty patients whom were subjected to myringoplasty for the treatment of perforated tympanic membrane. Each of the patients was subjected to a detailed history and examination of ear, nose, paranasal sinuses and throat to rule out any focus of infection, which could influence the result of type (I) tympanoplasty. Nine Patients were underwent myringoplasty with temporalis fascia while for the other Thirty-one patients the tragal cartilage was applied, patients of 16 years old and above were selected in the study. This study was carried out during the period from January 2016 till January 2017 at otolaryngology department, tertiary referral hospital in Erbil, Kurdistan-Iraq. Results: Majority of the subjects shows mild to moderate hearing impairment. No significant differences were detected between the two study groups regarding side of perforation (p = 0.134), size of perforation (p = 0.175), and site of perforation (p = 0.182). None of them had air-bone gap above 40 dB. The postoperative analysis showed that the graft uptake was more in the cartilage group (83.9%) than the fascia group (66.7%) but the difference was not significant (six months post operatively) (p = 0.984). The mean hearing gain was 14.19 + 6.8 dB in the cartilage group, compared with 16.11 + 10.2 dB in the fascia group (p = 0.608).