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Zakariya Yahya Al Riyami ShadenCorresponding author
Objective The repair of the tympanic membrane has been attempted with large variety of synthetic, homologous and autologous tissue; however, temporalis fascia and cartilage-perichondrium are used most commonly today. Study Design This is a prospective study of patients confirmed to have CSOM and operated during the years of 2012-2013 at Al Nahdha Hospital, Muscat, Sultanate of Oman. The patients were followed up postoperatively at which we compared the graft success rate and level of hearing improvement. Setting ENT clinic at Al Nahda hospital Subjects Patients who presented to the ENT clinic at Al Nahda hospital, operated in the period between 2012 and 2013, diagnosed as CSOM and meeting our inclusion criteria. Methods We compared the outcome of the repair of the tympanic membrane perforation using temporalis fascia graft versus cartilage perichondrium grafts. Results 100% of the cartilage-perichondrium group showed a successful graft uptake in comparison to 98.9% in the temporalis fascia. Our data did not show significant differences in the average air bone gap change in both groups. Conclusion Both cartilage-perichondrium and temporalis fascia provide viable autograft material. Both achieve comparable and excellent graft uptake. Completion of our study is needed to study the hearing restoration in both groups.
Asrar Ahmed LatifiCorresponding author Department of ENT, Buraidah Central Hospital, Buraidah,AlQassim-KSA
Objectives: The study was aimed to find out which of the two techniques, medial or lateral side of the temporalis fascia graft was better in underlay method for correcting the perforations of the tympanic membrane keeping all other factors constant. Methods: We designed a prospective randomized study from Jan 2010 to Jan 2013 at Buraidah Central Hospital, Al Qassim, Saudi Arabia. Eighty patients having dry central; moderate, large and subtotal perforations of the tympanic membrane were subjected for tympanoplasty type –I by underlay technique. In 41 patients the temporalis fascia graft was placed with medial (rough) side up (Technique-I) and 39 patients the graft was placed with the lateral (smooth) side up (Technique-II). Results: The graft take up rate was 95.1% in technique-I and 87.2% in technique -II. Failure rate was 4.9% in technique – I and 12.8% in technique – II. Conclusion: Technique – I was judge to be giving better result because: 1.Rough surface of the medial side of the graft after moistening enhances wetting, increases the critical surface tension and broadens the contact surface. 2.The friction due to rough surface resists displacement forces between the graft and remains of the tympanic membrane. 3.Rough surface of the medial side of the temporalis fascia increases the adhesion power and increases the overlap between the two surfaces. To the best of our knowledge this is the only such prospective study for this method.