Evaluation of Graft Uptake and Hearing Assessment after Palisade Myringoplasty

Abstract

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.

Graft Uptake and Hearing After Endoscopic Palisade Cartilage Myringoplasty at Nepal Medical College Teaching Hospital

“…The age range of the patients was also similar to ours with more patients in the younger age groups. 10,11 Our study had a female preponderance whereas other studies showed males who were affected by the condition undergoing surgery. 11,12 Ear surgery was revolutionized initially by the introduction of the monocular microscope in 1921 and then even further in 1922 by Gunnar Holmgren who is responsible for the development of the binocular microscope.…”

“…10,11 Our study had a female preponderance whereas other studies showed males who were affected by the condition undergoing surgery. 11,12 Ear surgery was revolutionized initially by the introduction of the monocular microscope in 1921 and then even further in 1922 by Gunnar Holmgren who is responsible for the development of the binocular microscope. 13 This helped illuminate and magnify the surgical field while freeing up both hands to operate on the ear.…”

“…Our study showed a graft uptake of 91.93%, which is comparable to other studies, where the uptake ranged from 88% to 95.24%. 11,12,30,31 Graft uptake rates even in children were similar to adults. Whereas, a study showed 85% graft uptake in palisade cartilage group and 86.3% in the onepiece group.…”

Five years of local democracy in federal Nepal (2017–2022)

“…(2023) discuss, Nepal has experimented with three diverse generations of local democracy in the last 70 years. The first generation (before the 1960s) involved an evolutionary local democratic practice in which the central government exercised excessive power to determine boundaries, structures, and leaders (or Panchas) to form local governments (KC, 1976). The second generation (1960–1990) advanced the development of local democracy in Nepal by promulgating legislation to establish rural and urban municipalities, although such legislation is always contested in terms of its democratic quality (Dharamdasani, 1984).…”