Introduction: Cartilage as a graft for closure of tympanic membrane has got superior benefits than other usual grafts (temporalis fascia and perichondrium). Cartilage supported myringoplasty with palisade technique has good result of graft uptake rate, even under difficult conditions. This technique brings very good functional and better long-term results. This study is done to assess graft uptake rate and hearing improvement after myringoplasty with cartilage palisade technique. Methods: It is a descriptive, hospital based observational study done at Manipal Teaching Hospital, Pokhara between 2014-2017. A total of 45 patients aged between 13 years and 44 years diagnosed with chronic otitis media-mucosal were taken. Pure tone audiometry was done before and six months after surgery. Graft uptake and Post-operative hearing gain was evaluated after six months. Statistical analysis was done by Statistical Package for Social Sciences version 16.0. Statistical significance was set at P<0.05. Results: Graft uptake rate was 41 (91.1%). The mean pre-and post-operative pure tone average were 26.88dB and 8.44dB respectively. The post-operative hearing gain was 18.36dB. Hearing improvement after surgery was found to be statistically highly significant with P<0.001. Conclusions: Cartilage supported myringoplasty using palisade technique is preferred for chronic otitis media-mucosal with large and sub-total tympanic membrane perforation.

Introduction: Underlay technique myringoplasty is most commonly used technique to repair tympanic membrane perforation by temporalis fascia graft and Trans-tympanic pop-in technique is an another technique that allows temporalis fascia graft placement medial to tympanic membrane remnant through the perforation without the need for tympano-meatal flap elevation. This study was undertaken to find the prevalence of perforated graft in underlay and Pop-in Technique Myringoplasty. Methods: This descriptive cross-sectional study was done at Manipal teaching hospital, Pokhara, Nepal and comprises of 86 patients between January 2014 and June 2015. Patients undergoing Underlay Trans-canal approach by tympano-meatal flap elevation and Trans-canal, Trans-tympanic pop-in technique were included. Sample size calculation was done and convenient sampling method was applied. Point estimate at 95% CI was done for binary data along with frequency and proportion. The descriptive statistical analysis was done. Results: The prevalence of perforated graft was 15 (17.4%) at 95% Confidence Interval (39.75-60.25%).In underlay technique there were 8 (18.60 %) perforation and 35 (81.39%) were intact while in pop-intechnique there were 7 (16.27%) perforation and 36 (83.72%) were intact. The postoperative meanPure Tone Average (PTA) of underlay was 9.53 and pop-in was 8.31. The mean Pure Tone Average(PTA) gain after underlay technique was 16.095 and pop in technique was 16.87. Conclusions: Trans-tympanic pop-in myringoplasty gives similar hearing & graft uptake results when compared with tympano-meatal flap method of underlay myringoplasty done by trans-canal.