Vishal Pathania, Kamal Goyal, Nishtha Saini, Jasdeep Monga
BACKGROUND A widely accepted technique used for eroded incudostapedial joint or partially eroded incus is tympanoplasty with remodelled incus or malleus. An alternate method used for grafting is using PORP with cymba conchal cartilage interface. This manuscript is a study which compares outcomes of remodelled autoincus with Teflon PORP with cartilage interface. The aim of the study is to compare the restoration of hearing, postoperatively, in patients who underwent tympanoplasty for eardrum perforation with IS joint erosion with chronic otitis media (COM) using remodelled autossicle with Teflon PORP. MATERIALS AND METHODS In our study of 90 patients, patients presented with chronic otitis media and eardrum perforation and were followed for at least 6 month post operatively. In 45 patients, temporalis fascia grafts with remodelled incus and the rest (45 patients) had PORP (Teflon) with conchal cartilage interface. Setting- Department of Otorhinolaryngology, SGT Medical College, Budhera, Gurugram, Haryana, India. Study Design- A total number of 90 surgically fit cases of perforation of the tympanic membrane were selected with moderate conductive hearing loss, who needed surgery of tympanoplasty with reconstruction. Study Period- Feb. 2014 to Feb. 2017. RESULTS Our data indicates that remodelled incus provided satisfying hearing (post-operative AB gap <20 dB) improvement in 43/45(95.6%) patients whereas in the PORP with cartilage interface, we achieved satisfying hearing improvement in 41/45(91.1%) patients. All patients with remodelled incus had dry and complete uptake of graft. Extrusion of graft where PORP was used seen in 2/45(4.4%) patients. CONCLUSION The primary objective of middle ear and mastoid surgery for cases of COM with perforation is to achieve a dry ear and hearing improvement postoperatively. The main aim of this study is to compare the restoration of hearing, postoperatively, in patients who underwent tympanoplasty for COM using autoincus or Teflon PORP. Both remodelled incus & PORP provided satisfying hearing (post-operative AB gap <20 dB) improvement in >90% patients.
