Evaluation of healing and hearing of grafted materials used in tympanoplasty
Journal Title: Medpulse International Journal of ENT - Year 2018, Vol 5, Issue 3
Abstract
Problem Statement: Tympanoplasty operation could prevent recurrent infection from external canal source by making the ear waterproof. It also would convert the open middle ear into a cul – de – sac, so that free flow of air could prevent the infected mucus up the Eustachian tube from the nasopharynx. So by this simple tympanoplasty operation the ear could also be protected from further damage by the diseased process. Methods: The present study was carried out in the otolaryngology Department of Darbhanga Medical College and Hospital, 110 subjects were selected from the outpatient department of otolaryngology, 47 subjects were male and 63 were female ranging from 12 to 50 years. 104 ears were operated under local anaesthetic infiltration with 2% lignocaine in adrenaline (1:1,00,000). Of these patients premeditation was given as follows in 54 cases of Large to moderate size perforation operated post aurally. Result: After elevating the posterior tympanomeatal flap in 60 cases of large and moderate size perforation. The graft so preserved (Temporalis fascia. Tragal perichondrium and areolar tissue was placed by underlyay technique i.e. the graft material was placed in between the handle of the malleus and the elevated tympanomeatal flap. The tympanomeatal flap was then reflected back over the grafting tissue to its original position. 110 Patients suffering from unilateral chronic suppurative otitis media had undergone Type –I tympanoplasty. 104 cases were operated under local anaesthesia and 6 cases were operated under general anesthesia. Four types of autogeneus tissues were used as grafting material. Temporalis fascia was used in 40 cases, Tragal perichondrium in 10 cases, Areolar tissue in 10 cases, and Fat from Lobule of same ear in 50 cases. The age of the subject in this present study ranged from 13 years to 48 years. The maximum numbers of subjects were in age group 21-30 year, followed by 31 subjects in 30-40 years, followed by 27 and 14 subjects in 11-20 year and 40-50 years age group respectively Mean age was 28.9 years. Conclusion: The younger age group had less impairment of hearing than that of the older age group in chronic suppurative otitis media with central perforation. It is also observed that the larger the size of the perforation greater was the degree of hearing impairment pre operatively. Post operatively also successful hearing was achieved only in 63% of patients with large perforation.
Authors and Affiliations
M K Bose, Manoj Kumar
Keywords
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