COMPARATIVE STUDY BETWEEN TEMPORALIS FASCIA AND TRAGAL PERICHONDRIUM GRAFT BY UNDERLAY MYRINGOPLASTY VIA TRANSCANAL APPROACH

Abstract

Tarun Guha, Rakesh Tripura, Binay Debbarma

BACKGROUND Myringoplasty is the surgical method of repairing perforated tympanic membrane. Among the different techniques used, onlay and underlay are widely practised. Autologous graft materials temporalis fascia, tragal perichondrium, cartilages, fascia lata are useful. Aims and Objectives- To compare temporalis fascia and tragal perichondrium graft in term of graft uptake rate and improvement of hearing. MATERIALS AND METHODS This is a prospective study conducted at Agartala Government Medical College, Tripura during 2016 July-2017 December on 60 patients having dry central tympanic membrane perforation in tubotympanic type of CSOM. Myringoplasty was done via trans-canal approach by inlay technique in all the cases using temporalis fascia in 30 cases and tragal perichondrium in 30 cases after random selection of the samples. RESULTS The graft uptake rate was 93.33% in temporalis fascia and 86.66% in tragal perichondrium. The graft uptake rate was slightly better for temporalis fascia however there was no significant difference (P> 0.05). 83.33% of the patients who underwent myringoplasty with temporalis fascia grafting had post-operative A-B gap of less than 15 db and 76.66% of the patients who underwent myringoplasty with tragal perichondrium grafting had post-operative A-B gap of less than 15 db. Based on post-operative A-B gap, the results were better with temporal fascia but with no significant difference. CONCLUSION Both the temporalis fascia and tragal perichondrium are excellent graft materials for myringoplasty. Temporalis fascia has shown better uptake (93.33%) and hearing improvement (83.33%) than tragal perichondrium where it 86.66% and 76.66% respectively but there is no statistical significant difference (P>0.05).

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