A Comparative Study on Morphological and Audiological Outcome in Type Ι Tympanoplasty for Chronic Otitis Media Mucosal Disease Using Temporalis Fascia versus Cartilage Graft

Abstract

Objective: To compare the morphological and audiological outcome of Type I tympanoplasty in Chronic otitis media mucosal disease using temporalis fascia and cartilage graft. Materials and Methods: A prospective comparative study among 110 patients with complaints of ear discharge and hearing loss due to Chronic otitis media mucosal disease who underwent Type I tympanoplasty. There were 52 patients where cartilage graft was used and 58 patients where temporalis fascia graft was used. The pre-operative clinical and audiological findings of the study subjects were noted using a proforma. In the post-operative period, they were followed up after 3 months and 6 months. At 3 rd month, patients were assessed for perforation closure and audiological evaluation by Tuning Fork Test and Pure Tone Audiometry. At 6 th month patients were subjected to clinical examination for integrity of tympanic membrane, PTA and Tympanometry. Results: Otorrhea was the commonest presenting complaint and majority had a large central perforation. The preoperative hearing loss was between 25dB to 45 dB. Majority of the cases had post aural approach for surgery. Tympanosclerosis was seen in 24 patients. Temporalis fascia graft was used in 58 patients, and cartilage graft in 52 patients. Among the temporalis fascia group graft failure was seen in 19 cases while in cartilage graft group there was only 3 cases. The AB gap closure of more than or equal to 10 dB in temporalis fascia was 82.8% while that in cartilage graft was 94.2%. The tympanometry curve of A or C was considered as a successful outcome. In 53% of patients with cartilage graft A or C was obtained, while in temporalis fascia graft group it was 47%. In the short term follow up of 6 months it was found that cartilage graft had reduced chance of re-perforation and better hearing