Temporalis Fascia Graft Underlay Technique for Type (1) Tympanoplasty in Chronic Otitis Media

Abstract

Background: Myringoplasty is a procedure used to seal a perforated tympanic membrane by using a graft material; temporalis fascia graft was most commonly used.Objective: To study the success rate of myringoplasty operation to close tympanic membrane perforation. Methodology: A prospective study of (40) selected patients with tympanic membrane perforation had undergone myringoplasty in Al-Imamain Al-Kadimain medical city over a period of (18) months (January2011-June2012). Preoperative and postoperative examinations of the patients were done clinically, radiologically and audio logically. All cases operated under general anesthesia and temporalis fascia graft was used in all cases. At the end of follow up period (4-6) months, an intact graft and hearing improvement considered a rule of success. Data was analyzed by chi-square (X2). Results: Generally from the whole number (40) patients whom undergo tympanoplasty type-1(myringoplasty), the success rate was (85%). With small perforation the success rate was (100%) while in total perforation was (75%). Also we found that the success rate in posterior perforation was high (91.6%) in comparison to the anterior perforation (83.3%).The patients were selected despite activity of the diseased ear with exclusion of all patients who had (cholesteatoma, ossicular dislocation or adhesion, granulation tissue and those with hearing loss of more than 40dB. Discussion was made with the presence or not of other procedures (exploration of mastoid bone) and its effects on the results of myringoplasty. Conclusion: Temporalis fascia graft underlay technique of type-1 tympanoplasty is an effective method for closure of tympanic membrane perforation with a success rate of (85%). Recommendation: Sealing of perforated tympanic membrane by using other types of graft materials and other surgical procedures can be done.