Evaluating the outcome of type I Tympanoplasty with cortical mastoidectomy using temporalis fascia graft with and without tragal cartilage support

Abstract

Type 1 tympanoplasty with graft helps in closure of perforation thereby arresting otorrhoea and improvement in hearing. Selecting a graft in tympanoplasty with cortical mastoidectomy is still a debatable topic among ENT surgeons across the world. Cortical mastoidectomy is opted by many for good mastoid ventilation and disease clearance in chronic otitis media.Evaluating postoperative outcomes of patients in graft uptake and hearing improvement in cortical mastoidectomy with type I tympanoplasty using temporalis fascia graft with and without tragal cartilage support in quiescent mucosal type of chronic otitis media with conductive hearing loss. A retrospective study of 60 patients who underwent cortical mastoidectomy with type I tympanoplasty were screened and taken for study. Group A had 30 patients who had underwent tympanoplasty with temporalis fascia supported by cartilage and group B included 30 patients who underwent tympanoplasty with temporalis fascia alone. They were followed periodically for 6 months and the outcome of graft uptake and hearing improvement were compared. Successful Graft uptake in group A was 90% and group B was 93%. Hearing improvement in group A was 83% and group B was 87%. Type I Tympanoplasty with cortical mastoidectomy gives a good outcome in terms of graft uptake and hearing improvement in chronic otitis media, but our study showed no significant difference between the two types of grafts used for tympanoplasties. The selection of patients, the condition of middle ear, postoperative asepsis and compliance of the patient and periodic follow up remains the crux in best outcome.