Comparison of endoscopic tympanoplasty, cartilage vs. temporalis fascia in chronic suppurative otitis media with inactive mucosal disease: A prospective randomised study.

Cartilage tympanoplasty Chronic suppurative otitis media Endoscopic tympanoplasty Temporalis fascia

Journal

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937

Informations de publication

Date de publication:
04 Aug 2024
Historique:
received: 21 04 2024
accepted: 29 07 2024
medline: 5 8 2024
pubmed: 5 8 2024
entrez: 4 8 2024
Statut: aheadofprint

Résumé

The introduction of endoscopy into middle ear has open up new opportunities for minimal invasive temporal bone surgery. The present study was planned to compare anatomical and functional outcome in patients who underwent endoscope assisted tympanoplasty using cartilage and temporalis fascia graft. The present prospective observational randomized study was carried out in the Department of Otorhinolaryngology of a tertiary care teaching hospital of Rajasthan, India from September 2020 to July 2021. Fifty patients of age group 18-60 years, with diagnosis of chronic otitis media having inactive mucosal disease were enrolled in the study and divided into two groups viz. cartilage (group I) and temporalis fascia group (group II). Each patient postoperatively underwent otoscopic examination of ear and pure tone audiometery at 8 weeks and 3rd month. Local wound condition, graft uptake and healing and hearing were assessed and compared. Graft uptake was 92% in cartilage group and 84% in temporalis fascia group. Air conduction and air-bone gap of patients in both the groups showed significant improvement after 3 months of surgery. (p˂0.05) Regarding bone conduction, both groups had shown non-significant changes. (p > 0.05) Hearing gain was comparable on both groups which was 6.71dB in cartilage group vs. 5.9 dB in other group. The present study showed that graft placement time for temporalis fascia graft was less than cartilage graft, but the difference was insignificant. Hearing improvement, graft uptake and clinical improvement were found to be statistically insignificant between both groups.

Sections du résumé

BACKGROUND BACKGROUND
The introduction of endoscopy into middle ear has open up new opportunities for minimal invasive temporal bone surgery. The present study was planned to compare anatomical and functional outcome in patients who underwent endoscope assisted tympanoplasty using cartilage and temporalis fascia graft.
METHODS METHODS
The present prospective observational randomized study was carried out in the Department of Otorhinolaryngology of a tertiary care teaching hospital of Rajasthan, India from September 2020 to July 2021. Fifty patients of age group 18-60 years, with diagnosis of chronic otitis media having inactive mucosal disease were enrolled in the study and divided into two groups viz. cartilage (group I) and temporalis fascia group (group II). Each patient postoperatively underwent otoscopic examination of ear and pure tone audiometery at 8 weeks and 3rd month. Local wound condition, graft uptake and healing and hearing were assessed and compared.
RESULTS RESULTS
Graft uptake was 92% in cartilage group and 84% in temporalis fascia group. Air conduction and air-bone gap of patients in both the groups showed significant improvement after 3 months of surgery. (p˂0.05) Regarding bone conduction, both groups had shown non-significant changes. (p > 0.05) Hearing gain was comparable on both groups which was 6.71dB in cartilage group vs. 5.9 dB in other group.
CONCLUSIONS CONCLUSIONS
The present study showed that graft placement time for temporalis fascia graft was less than cartilage graft, but the difference was insignificant. Hearing improvement, graft uptake and clinical improvement were found to be statistically insignificant between both groups.

Identifiants

pubmed: 39098959
doi: 10.1007/s00405-024-08879-4
pii: 10.1007/s00405-024-08879-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

Rupa V, Jacob A, Joseph A (1999) Chronic suppurative otitis media: prevalence and practices among rural south Indian children. Int J Pediatr Otorhinolaryngol 48(3):217–221. https://doi.org/10.1016/s0165-5876(99)00034-8
doi: 10.1016/s0165-5876(99)00034-8 pubmed: 10402118
Trojanowska A, Drop A, Trojanowski P, Rosińska-Bogusiewicz K, Klatka J, Bobek-Billewicz B (2012) External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms. Insights into Imaging 3(1):33–48. https://doi.org/10.1007/s13244-011-0126-z
doi: 10.1007/s13244-011-0126-z pubmed: 22695997
Brar S, Watters C, Winters R, Tympanoplasty [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://www.ncbi.nlm.nih.gov/books/NBK565863/
Dave V, Sharma S (2019) Comparative Analysis of Fascia Lata and Cartilage Graft in Revision Type 1 Tympanoplasty. Indian J Otolaryngol head neck Surgery: Official Publication Association Otolaryngologists India 71(Suppl 2):1232–1237. https://doi.org/10.1007/s12070-018-1286-7
doi: 10.1007/s12070-018-1286-7
Ma L, Fei B (2021) Comprehensive review of surgical microscopes: technology development and medical applications. J Biomed Opt 26(1):010901. https://doi.org/10.1117/1.JBO.26.1.010901
doi: 10.1117/1.JBO.26.1.010901 pubmed: 33398948 pmcid: 7780882
Akyigit A, Sakallıoglu O, Karlidag T (2017) Endoscopic tympanoplasty. J Otology 12(2):62–67. https://doi.org/10.1016/j.joto.2017.04.004
doi: 10.1016/j.joto.2017.04.004
Lou ZC (2020) Endoscopic myringoplasty: comparison of double layer cartilage-perichondrium graft and single fascia grafting. J Otolaryngol - head neck Surg = Le J d’oto-rhino-laryngologie et de chirurgie Cervicofac 49(1):40. https://doi.org/10.1186/s40463-020-00440-7
doi: 10.1186/s40463-020-00440-7
Gowrishankar M, Athiyaman K, Suresh V, Gayathiri R, Natarajan S (2020) A comparative study of temporalis fascia grafting techniques in cortical mastoidectomy with type 1tympanoplasty patients in tertiary care hospital. Int J Otorhinolaryngol Head Neck Surg 6:1612–1616. https://doi.org/10.18203/issn.2454-5929.ijohns20203559
doi: 10.18203/issn.2454-5929.ijohns20203559
Booth JB (1974) Myringoplasty. The lessons of failure. J Laryngol Otol 88(12):1223–1236. https://doi.org/10.1017/s0022215100079950
doi: 10.1017/s0022215100079950 pubmed: 4452806
Jackler RK, Schindler RA (1984) Role of the mastoid in tympanic membrane reconstruction. Laryngoscope 94(4):495–500. https://doi.org/10.1288/00005537-198404000-00013
doi: 10.1288/00005537-198404000-00013 pubmed: 6708693
Adkins WY, White B (1984) Type I tympanoplasty: influencing factors. Laryngoscope 94(7):916–918. https://doi.org/10.1288/00005537-198407000-00011
doi: 10.1288/00005537-198407000-00011 pubmed: 6738270
Kulduk E, Dundar R, Soy FK, Guler OK, Yukkaldiran A, Iynen I, Bozkus F (2015) Treatment of large tympanic membrane perforations: medial to Malleus Versus lateral to Malleus. Indian J Otolaryngol head neck Surgery: Official Publication Association Otolaryngologists India 67(2):173–179. https://doi.org/10.1007/s12070-015-0846-3
doi: 10.1007/s12070-015-0846-3
Vadiya S, Parikh V, Shah S, Pandya P, Kansara A (2016) Comparison of modified Cartilage Shield Tympanoplasty with Tympanoplasty using Temporalis Fascia only: retrospective analysis of 142 cases. Scientifica 2016:8092328. https://doi.org/10.1155/2016/8092328
doi: 10.1155/2016/8092328 pubmed: 27559489 pmcid: 4983392
Uzun C, Cayé-Thomasen P, Andersen J, Tos M (2003) A tympanometric comparison of tympanoplasty with cartilage palisades or fascia after surgery for tensa cholesteatoma in children. Laryngoscope 113(10):1751–1757. https://doi.org/10.1097/00005537-200310000-00017
doi: 10.1097/00005537-200310000-00017 pubmed: 14520101
Yegin Y, Çelik M, Koç AK, Küfeciler L, Elbistanlı MS, Kayhan FT (2016) Comparison of temporalis fascia muscle and full-thickness cartilage grafts in type 1 pediatric tympanoplasties. Braz J Otorhinolaryngol 82(6):695–701. https://doi.org/10.1016/j.bjorl.2015.12.009
doi: 10.1016/j.bjorl.2015.12.009 pubmed: 27068884 pmcid: 9444745
Kazikdas KC, Onal K, Boyraz I, Karabulut E (2007) Palisade cartilage tympanoplasty for management of subtotal perforations: a comparison with the temporalis fascia technique. Eur Archives oto-rhino-laryngology: Official J Eur Federation Oto-Rhino-Laryngological Soc (EUFOS) : Affiliated German Soc Oto-Rhino-Laryngology - Head Neck Surg 264(9):985–989. https://doi.org/10.1007/s00405-007-0291-3
doi: 10.1007/s00405-007-0291-3
Özdamar K, Sen A (2020) Comparison of temporal muscle fascia and tragal cartilage perichondrium in endoscopic type 1 tympanoplasty with limited elevation of tympanomeatal flap. Braz J Otorhinolaryngol 86(4):483–489. https://doi.org/10.1016/j.bjorl.2019.06.014
doi: 10.1016/j.bjorl.2019.06.014 pubmed: 31431343
Khan MM, Parab SR (2015) Comparative study of sliced tragal cartilage and temporalis fascia in type I tympanoplasty. J Laryngol Otol 129(1):16–22. https://doi.org/10.1017/S0022215114003132
doi: 10.1017/S0022215114003132 pubmed: 25602596

Auteurs

Ashish Nagar (A)

Department of ENT, Kota medical college, Kota, Rajasthan, India.

Shailja Prajapati (S)

Department of ENT, Sawai Man Singh medical college, Jaipur, Rajasthan, India. shailja.2892@gmail.com.

Digvijay Singh Rawat (DS)

Department of ENT, Jawaharlal nehru medical college, Ajmer, Rajasthan, India.

Yogesh Aseri (Y)

Department of ENT, Jawaharlal nehru medical college, Ajmer, Rajasthan, India.

Classifications MeSH