A comparative study of tympanoplasty with temporalis fascia graft versus tragal cartilage perichondrium graft.

The study was carried out on 50 patients with central perforation in tympanic membrane (dry & inactive stage). The study was done in the department of ENT, MIMS medical college, Nellimarla, Vizianagaram over a period of one year. The study was done on comparison between tympanoplasty procedure using temporalis fascia as graft versus cartilage composite graft. Precise history was taken from respective patients in detail and were examined clinically. Patients with dry perforation with good cochlear reserve, intact and mobile ossicular chain, functioning Eustachian tube were selected randomly for the operation. Tympanoplasty procedure using temporalis fascia as graft was done in 50% (n=25) patients and tympanoplasty procedure using cartilage composite graft was done in 50% (n=25) patients. In this study the age range of patients were from 13 to 50 years, the mean age was 26.62 years, the number of male and female was equal. Right sided disease was predominant in our study and the mean duration of symptom was 11.24 months. The mean pre-operative hearing loss (pure tone average by pure tone audiometry) was 37.84±4.65 dB and mean pre-operative airbone gap was 22.84±4.65 dB. Post-operative Mean air conduction was 23.48±5.54 dB among them 24.2 ±6.26 dB in the fascial group and 22.76±4.73 dB in the cartilage group. This result is not statistically significant. Post-operative mean air-bone gap was 13.84±5.94 dB among them 14.76±5.6 dB in fascial group and 12.92 ±6.23 dB in the cartilage group which is not significant stastistically. Successful graft take-up rate of 88.00% (n=44). The overall success rate among tympanoplasty using temporalis fascia graft(GROUP A) and tympanoplasty using composite cartilage graft (GROUP B) technique were 84.00% (n=21) and 92.00% (n=23) respectively. 12.00% (n=6) patients were marked as failure cases during postoperative follow up period. The overall failure rate among tympanoplasty using temporalis fascia graft (GROUPA) and tympanoplasty using composite cartilage graft (GROUP B) technique were 16.00% (n=4) and 8.00% (n=2) respectively. So the distribution of surgical outcome in terms of success rate or failure rate was statistically insignificant in the two study groups (p=0.384). So the distribution of surgical outcome in terms of success rate or failure rate cartilage composite graft gives a definitely better result than temporalis fascia graft. However, the two method did not differ significantly in terms of hearing improvement. [ABSTRACT FROM AUTHOR]