Comparison of results between cartilage tympanoplasty and temporalis fascia tympanoplasty.
Keywords:Cartilage Tympanoplasty, Pure Tone Audiometry, Temporalis Fascia Tympanoplasty
Objectives: To compare the results after performing cartilage tympanoplasty and temporalis fascia tympanoplasty. Study Design: Analytical/Observational study. Setting: Two different hospitals. Social Security Landhi Hospital Karachi and Al-Tibri Medical College & Hospital Malir Karachi. Period: July 2017 to June 2018. Material & Methods: 76 patients were included for this study with both genders who had dry tympanic membrane perforations after taking antibiotics. Age ranges between 18 to 40 years. Patients were divided into two groups, group-I and group-II. In group-I, temporalis fascia tympanoplasty performed under microscope with post aural approach and in group-II, tragal cartilage tympanoplasty performed with the oto-endoscope via permeatal approach. Observed and compare the results of both procedure after 1 day, after 1 week, after 1 month and after 2 months. Variables were bleeding, pain, hearing assessment with pure tone audiometry (PTA) in which air conduction, bone conduction and air-bone gap (AB-gap) measured, Vomiting, vertigo and duration of surgery. Weber test done in all patients on very next day after surgeries in both groups to exclude the damage of vestibulo-cochlear system. Integrity of grafted tympanic membrane examined with oto-endoscope. Results: Weber test performed on 1st post-operated day, it was lateralized towards operated ear which indicate the safety of inner ear. Vomiting and vertigo not found after tympanoplasty in both groups which indicate the safety of vestibular system. There was no blood soaked guaze seen after tympanoplasty in group-II (cartilage tympanoplasty). Bleeding was less in group-II as compare to group-I. 37 patients out of 38 had intact grafted tympanic membrane in group-I while all (38) patients had intact grafted tympanic membrane in group-II. Mean duration of surgery was 65.1 +3.7 minutes in group-II (cartilage tympanoplasty) and mean duration of surgery was 82.0 + 5.6 minutes in group-I (temporalis fascia tympanoplasty). P value was <0.001 is significant. Duration of surgery was less in group-II. Hearing was also improved in both groups after tympanoplasty. Post-operated AB-gap reduction seen in all patients of both groups. Conclusion: Results of both temporalis fascia and cartilage tympanoplasty were almost same but cartilage tympanoplasty is better because it consumed less time, less post-operated bleeding and perception of pain were also less.