STUDY OF DIFFERENT TYPES OF GRAFT MATERIALS USE IN TYPE - I TYMPANOPLASTY AT ENT DEPARTMENT OF SKMCH, MUZAFFARPUR, BIHAR

Abstract

Background: The present study was undertaken to compare the results of various autogenous tissues as grafting materials for the repair of the tympanic membrane defect. As all the materials used previously were not easily available. So the present study comprised of the materials, which were easily available in adequate amount. These were temporalis fascia, tragalperichnodrium, areolar tissue and Ear lobule fat. Methods: In 100 subjects tympanoplasty operation was performed in 100 ears. The age of subjects ranged from 11 years to 50 years with mean age being 28.9 years. 33 cases were male and 67 cases were female. Majority (62%) of them were residing in rural areas and rest (38%)were from urban population. The period of study was from May 2019 to April 2020 starting from the pre-operative assessment to post– operative follow up all findings were noted in specific proforma. All of them attended ENT outpatient department of Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, with the chief complaints of discharging ear of varying duration. Slight impairment of hearing of varying degree was also complained of. Few of them presented with active stage of the disease and they were treated conservatively so that they attained the criteria as mentioned previously for myringoplasty operation of the present study. Results: Temporal fascia – None of the operated case reached the excellent result of post operative A-B gap closure by 0 – 10 dB. 23 cases showed good A-B gap closure of 11 – 20 dB followed by 9 cases with fair A – B gap closure of 21 – 30 dB and 5 cases showed poor result of >30 dB A-B gap closure. Tragal perichondrium –None of the operated case reached the excellent result of post operative A-B gap closure by 0 -19 dB 5 cases showed good A-B gap closure by 11 -20 dB, followed by 3 cases of fair A-Bgap closure 21 – 30 dB and 1 case of poor result with >30 dB A- B gap closure. Areolar tissue – None of the operated case reached the excellent result of post operative A-B gap closure by 0 -10 dB. 6 cases showed good A-B gap closure by 11 – 20 dB, followed by 2 cases of fair i.e. 21 – 30 dB A- B gap closure. Ear Lobule fat – 8 out of 45 cases showed excellent result with post operative A-B gap closure by 0 – 10 dB followed by 32 cases with good A-B gap closure by 11 – 20 dB, followed by 5 cases of fair i.e. 21 – 30 dB A-B gap closure. Conclusion: Tympanoplasty using Fat from ear lobule has high success rate of 90% for tiny small perforations. It is an office procedure which is cost effective with minimum post operative morbidity. But it is an underused procedure. We should practice it more for the benefit of our patients. Further long term study with more number of patients and verities of graft materials are necessary to achieve detailed and accurate results.