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Arora M, Goel K, Sharma DK, Bhagat S, Yadav V, Aggarwal A. Outcomes of Palisade Cartilage Tympanoplasty in Chronic Otitis Media: Our Experience at a Tertiary Care Centre. Indian J Otolaryngol Head Neck Surg 2024; 76:758-763. [PMID: 38440451 PMCID: PMC10908680 DOI: 10.1007/s12070-023-04274-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/09/2023] [Indexed: 03/06/2024] Open
Abstract
To evaluate the anatomical and functional success rates of palisade cartilage tympanoplasty in chronic otitis media. Thirty patients with chronic otitis media with subtotal perforation underwent palisade cartilage tympanoplasty and were assessed prospectively. The outcomes evaluated were graft uptake and hearing gain. Overall graft uptake was 90% with failure in 3 cases. The preoperative mean air conduction threshold was 22.087 ± 6.120 dB which was improved to 13.387 ± 5.253 dB postoperatively at 12 weeks which was statistically significant. The mean postoperative ABG closure was 8.700 dB with a p value of 0.001 which was statistically significant. Palisade cartilage tympanoplasty demonstrates that subtotal perforations, which are at high risk for graft failure, can be treated efficiently and a durable and resistant reconstruction of the tympanic membrane with reasonable hearing can be achieved.
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Affiliation(s)
- Manika Arora
- Department of Head and Neck Oncology, Medanta the Medicity Hospital, Gurgaon, Haryana India
| | - Khushboo Goel
- Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College, Patiala, Punjab India
| | - Dinesh Kumar Sharma
- Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College, Patiala, Punjab India
| | - Sanjeev Bhagat
- Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College, Patiala, Punjab India
| | - Vishav Yadav
- Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College, Patiala, Punjab India
| | - Ankita Aggarwal
- Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College, Patiala, Punjab India
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Lajdam GB, Alahmadi RA, Alhakami M, Ghaddaf AA, Abdulhamid AS, Alahmadi A, Abdelsamad Y, Hagr A. Comparison of temporalis muscle fascia and cartilage grafts for primary type 1 tympanoplasty: a meta-analysis of randomized controlled trials. Eur Arch Otorhinolaryngol 2023; 280:5153-5165. [PMID: 37540270 DOI: 10.1007/s00405-023-08170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE To compare the efficacy and safety of temporalis fascia (TF) with cartilage grafts for primary type 1 tympanoplasty in chronic otitis media (COM) patients. METHODS Computerized search was performed in MEDLINE, Embase, and CENTRAL. Eligible for inclusion were randomized controlled trials (RCTs) comparing TF and cartilage grafts in individuals with non-cholesteatoma COM and intact ossicles requiring type 1 tympanoplasty. Primary outcomes were graft success and hearing improvement, measured by the air-bone gap (ABG) closure. The secondary outcome was the occurrence of complications. Standardized mean differences (SMD) and odds ratios (OR) with 95% confidence intervals were calculated. RESULTS Eighteen RCTs that enrolled 1273 participants were found eligible. Data were reported at follow-up periods ranging from 6 weeks to 24 months. The pooled effect estimate revealed a higher and statistically significant graft success favoring cartilage grafts at 12 months (OR = 2.24, 95% CI 1.33-3.78) and 24 months (OR = 2.96, 95% CI 1.18-7.43). There was no significant difference between both grafts in post-operative ABG closure across all follow-up periods (6 weeks to 12 months). CONCLUSIONS Compared to TF, primary type 1 cartilage tympanoplasty offers better graft uptake rates and comparable postoperative hearing outcomes for COM patients.
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Affiliation(s)
- Ghassan Bin Lajdam
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
| | - Rana A Alahmadi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mohammed Alhakami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah A Ghaddaf
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ahmed S Abdulhamid
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
| | | | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
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Varma A, Bansal C, Pandey AK. An Exposition on Endoscopic Broad Palisade Cartilage Tympanoplasty: Procedural Illustrations and Connotations in Context of Audiological and Morphological Outcomes. Indian J Otolaryngol Head Neck Surg 2022; 74:4381-4387. [PMID: 36742903 PMCID: PMC9895713 DOI: 10.1007/s12070-021-03043-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/11/2021] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to evaluate graft take up rate and hearing improvement in type I and type III endoscopic tympanoplasty using broad palisade cartilage graft and to compare the results with other studies who have used single piece cartilage as graft. This retrospective observational descriptive study was done in a tertiary care hospital. This study included 64 cases, who met the inclusion criteria, which were operated over 2 years and were followed for 3 years. The results were evaluated using graft uptake rates and hearing improvement comparing the preoperative and postoperative air conduction threshold (ACT) and air bone gap closure (ABG). The graft take rate was 92.1% and 87.5% at the end of 1 year and 3 years respectively. The preoperative and post-operative air conduction threshold were 35 ± 6.0 dB HL and 17.5 ± 2.7 dB HL in type I tympanoplasty respectively (p value <0.0001) while in type III tympanoplasty, preoperative and post-operative air conduction threshold (ACT) were 43.3 ± 8.6 dB HL and 23.1 ± 4.2 dB HL respectively (p value <0.0001). The preoperative and postoperative air bone gap (ABG) were 29.0 ± 5.6 dB HL and 14.4 ± 4.20 dB HL in type I tympanoplasty respectively (p value <0.0001). In type III preoperative and post-operative air bone gap were 36. 1 ± 7.5 dB HL and 16.4 ± 3.3 dB HL respectively (p value < 0.0001). Endoscopic broad palisade cartilage tympanoplasty has similar outcomes in morphological and audio logical perspectives as single piece cartilage tympanoplasty. Further studies with long term follow up period are required to corroborate the result of this study.
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Affiliation(s)
| | - Chetan Bansal
- Department of ENT, Satya Pal Wahi ONGC Hospital, Dehradun, Uttarakhand India
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Chen K, Zhao R. Comparison of cartilage and temporalis fascia grafts in type 1 tympanoplasty: A meta-analysis. EAR, NOSE & THROAT JOURNAL 2022:1455613221137122. [PMID: 36300279 DOI: 10.1177/01455613221137122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
OBJECTIVE To systematically review the results of type 1 tympanoplasties with temporalis fascia (TF) vs cartilage grafts in patients with chronic otitis media. METHODS Eligible studies were identified from PubMed, Ovid, and EMBASE databases prior to November 2021. We analyzed the pure tone audiometry (PTA) and air-bone gap (ABG) data as continuous variables, and the success rate was analyzed as a dichotomous variable. RESULTS Forty-four studies, including 4582 patients, were eligible. The cartilage graft overall morphologic success rate was higher than that of the TF grafts (P < .001). In the palisade (P < .004) and island grafts (P < .001) subgroups, the analysis was significantly different. However, there was no significant difference in the inlay butterfly grafts subgroup. For hearing outcomes, the analysis revealed that TF grafts had a smaller mean post-operative ABG (P = .009). However, the subgroup analysis showed no significant difference in the mean post-operative ABG. For PTA, there was no significant difference in hearing improvement. However, the palisade cartilage graft subgroup resulted in a better hearing outcome than the TF graft subgroup in terms of the mean post-operative PTA (P = .007). There was no significant difference in the functional success rate or mean ABG gain. CONCLUSION Cartilage grafts have a better success rate than TF grafts in tympanoplasty. Both cartilage and TF tympanoplasty provided similar improvements in hearing outcome, while TF grafts generated a better outcome in post-operative ABG and palisade cartilage grafts in post-operative PTA. This may be related to the biological characteristics of the grafts. Further thorough studies need to be conducted.
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Affiliation(s)
- Kai Chen
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Zhao
- Otorhinolaryngology-Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Rasool S, Qureshi S, Varshney A, Hassan S, Kokab F, Naseeruddin K. Palisade Cartilage Tympanoplasty, an Alternative Surgical Approach for CSOM. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2022; 34:179-183. [PMID: 36035649 PMCID: PMC9392995 DOI: 10.22038/ijorl.2022.60937.3093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/28/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION The hearing outcome and graft take in patients of CSOM with sclerotic mastoids were studied using the novel technique of palisade cartilage tympanoplasty. Besides, it was compared with tympanoplasty type-1 above and over the cortical mastoidectomy in both groups. MATERIALS AND METHODS Out of 313 patients of CSOM, 125 had sclerotic mastoid and were included in the study. Palisade cartilage group patients were subjected to palisade cartilage tympanoplasty type-1. While as in the Temporalis fascia group patients, type-1 tympanoplasty was done using temporalis fascia as graft material. These procedures were performed in addition to cortical mastoidectomy done in all cases. RESULTS Statistically significant (P<0.001) mean postoperative hearing gain was achieved (> 20 dB) in both the groups with a reduction of AB gap to 13.3 & 11.79 dB, respectively. However, the post-surgery hearing outcomes achieved were similar in both groups (P=0.09). The overall graft take rate of 86% was seen in the Palisade cartilage group. The remaining 14% had graft take failure. The primary graft failure rate was 10% (5/50), and the secondary failure rate within six months of follow-up was 4% (2/50). The Temporalis fascia group graft take rate was higher (92%) than the Palisade cartilage group, with only 4 % (3/75) of cases having a primary graft failure rate. However, these findings (92% vs. 86%) were not statistically significant (P=0.2830). CONCLUSIONS As the hearing outcomes and graft take rates were comparable in the two groups, the present study highlighted the use of palisade cartilage tympanoplasty in patients of CSOM with sclerotic mastoids as an alternative method to tympanoplasty.
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Affiliation(s)
- Shahid Rasool
- Department of Otorhinolaryngology Head and Neck Surgery, Hamdard Institute of Medical Sciences, New Delhi, India.,Corresponding Author: Department of ENT-HNS, Hamdard institute of medical sciences, Apartment D-404 AMHR hostel jamia hamdard, New Delhi.110062. E-mail:
| | - Shifa Qureshi
- Department of Otorhinolaryngology Head and Neck Surgery, Hamdard Institute of Medical Sciences, New Delhi, India.
| | - Ashima Varshney
- Department of Otorhinolaryngology Head and Neck Surgery, Hamdard Institute of Medical Sciences, New Delhi, India.
| | - Simmi Hassan
- Department of Otorhinolaryngology Head and Neck Surgery, Hamdard Institute of Medical Sciences, New Delhi, India.
| | - Faiza Kokab
- Department of Otorhinolaryngology Head and Neck Surgery, Hamdard Institute of Medical Sciences, New Delhi, India.
| | - Khaja Naseeruddin
- Department of Otorhinolaryngology Head and Neck Surgery, Hamdard Institute of Medical Sciences, New Delhi, India.
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Zhou Q, Jin L, Song X, Zheng H, Huang Y. Endoscopic type 1 tympanoplasty: comparison of the effects of three different thicknesses grafts. Acta Otolaryngol 2022; 142:375-380. [PMID: 35549633 DOI: 10.1080/00016489.2022.2071987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The effects of graft thickness on tympanoplasty is uncertain. OBJECTIVE To compare the results of endoscopic tympanoplasty using different thicknesses of autologous tissues. METHODS This retrospective analysis included 186 patients who received type I tympanoplasty, divided into three main groups based of grafting material: perichondrium (A), cartilage-perichondrium (B), or cartilage-perichondrium plus additional perichondrium (C). Group A was subdivided based on whether the placement was inside (A1) or outside (A2) of the malleus. The hearing improvement, graft success rate, and surgery duration were analysed. RESULTS Statistical analysis showed significant hearing improvement in the three main groups (p < .001); recovery in group A occurred the earliest. Six months postoperatively, group A1 showed significantly greater hearing recovery compared with groups B and C (p < .05). There were no statistical differences the other groups (p > .05) or in the graft success rate among the three main groups (p = .235). The surgery duration of group A was significantly longer than that of groups B and C (p < .001). CONCLUSION AND SIGNIFICANCE Our results suggest that graft thickness affects hearing recovery; however, graft thickness does not affect the rate of grafting success. Endoscopic transplantation of the perichondrium is more difficult and requires more time.
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Affiliation(s)
- Qinshuang Zhou
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, China
| | - Lanlan Jin
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, China
| | - Xiaoxiao Song
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, China
| | - Haifeng Zheng
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, China
| | - Yideng Huang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, China
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Saini YK, Singhal P, Prabhu KPS, Nagaraj S, Amreen, Sharma S, Yadav R, Aeron BS, Munjal S, Sharma MP. Vertical Strut Ossiculoplasty: A Versatile Alternate to Conventional Techniques-A Randomized study. Indian J Otolaryngol Head Neck Surg 2021; 73:360-365. [PMID: 34471627 PMCID: PMC8364591 DOI: 10.1007/s12070-021-02614-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Various ossicular reconstruction materials and techniques have been described in literature using autologous ossicle, cortical bone, autologous cartilage, synthetic materials and implants like total/partial ossicular replacement prosthesis (TORP/PORP) etc., but it has always been a topic of controversy in terms of the efficacy, longevity and complications of the material or method used. MATERIAL AND METHODS This is a prospective, interventional, comparative, double-blind randomized control study which was done at a tertiary care center to compare outcomes of conventional and carved conchal cartilage (vertical strut) type III Tympanoplasty in terms of graft uptake and hearing gain. A total number of 52 cases were enrolled, randomized and allocated to 2 groups (26 each) i.e. group A (conventional type III) and group B (vertical strut technique). RESULTS Graft uptake was seen in 25 (96.16%) patients in group B while it was observed in 23 (88.5%) cases in group A. Hearing gains were also better in group B. CONCLUSION This study suggests that Vertical Strut technique can be studied further as it gives better gains in Air Conduction threshold and A-B Gap along with graft uptake as it provides better middle ear space and ossicular / tympanic membrane interface resulting in better hearing.
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Affiliation(s)
- Yogendra Kumar Saini
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, 302004 Rajasthan India
| | - Pawan Singhal
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, 302004 Rajasthan India
| | | | - Sushmitha Nagaraj
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, 302004 Rajasthan India
| | - Amreen
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, 302004 Rajasthan India
| | - Shivam Sharma
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, 302004 Rajasthan India
| | - Rajeev Yadav
- Department of Preventive and Social Medicine, SMS Medical College, Jaipur, India
| | | | | | - Man Prakash Sharma
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, 302004 Rajasthan India
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Xing C, Liu H, Li G, Li J, Li X. Type 1 tympanoplasty in patients with large perforations: Comparison of temporalis fascia, partial-thickness cartilage, and full-thickness cartilage. J Int Med Res 2021; 48:300060520945140. [PMID: 32790512 PMCID: PMC7543155 DOI: 10.1177/0300060520945140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to compare the results of different graft materials in type I tympanoplasty for patients with a large perforation of the tympanic membrane. Methods We performed a retrospective study on 180 patients with type I tympanoplasty. The patients were divided into three groups according to the repair materials used. Age, sex, pre- and postoperative hearing levels, mean air–bone gap, rate of graft success, hearing gain, and the postoperative graft failure rate were evaluated. We continued to follow-up the patients to 1 year after surgery. Results The air conduction threshold was significantly higher before the operation than after the operation in the temporalis fascia, partial-thickness cartilage, and full-thickness cartilage groups. Although the hearing gain in the temporalis fascia group and the partial-thickness cartilage group was higher than that in the full-thickness cartilage group, there was no significant difference in the graft success rate among the groups. Conclusions Temporalis fascia, partial-thickness cartilage, and full-thickness cartilage can be used as appropriate transplantation materials for tympanoplasty type I in patients with a large perforation. Temporalis fascia and partial-thickness cartilage may be best for improvement of hearing.
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Affiliation(s)
- Caixia Xing
- Department of Otolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, P.R. China
| | - Hong Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, P.R. China
| | - Guodong Li
- Department of Otolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, P.R. China
| | - Jianfeng Li
- Department of Otolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, P.R. China
| | - Xin Li
- Department of Otolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, P.R. China
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Shakya D, Nepal A. Long-term results of type I tympanoplasty with perichondrium reinforced cartilage palisade vs temporalis fascia for large perforations: A retrospective study. J Otol 2020; 16:12-17. [PMID: 33505444 PMCID: PMC7814073 DOI: 10.1016/j.joto.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/02/2022] Open
Abstract
Objective To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane (TM) perforations over 5 years follow-up period. Materials and methods This was a retrospective comparative study involving patients with chronic otitis media with large TM perforations. The patients underwent type I tympanoplasty using either perichondrium reinforced cartilage palisade (CP group) or temporalis fascia (TF group) as the graft via a transmeatal approach and under local anesthesia. Morphological and functional results were recorded at three- and five years follow-up. Demographic profiles including age and sex, surgery side, contralateral disease and graft uptake rate, as well as hearing outcomes, were compared between the two groups. Results At three years follow-up, graft uptake was 94.87% for perichondrium reinforced cartilage palisade and 80.7% for fascia, respectively, (p = 0.67). At five years follow-up, the uptake rate dropped to 87.17% in the CP group, but to 66.6% in the TF group (p=0.019). Hearing improved after surgery in both groups, and showed no significant difference between the two groups. Conclusion Over long-term, perichondrium reinforced palisade showed a statistically significant better outcome regarding graft uptake than temporalis fascia in type Itympanoplasty for large TM perforations with comparable audiometric results
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Affiliation(s)
- Dipesh Shakya
- Department of Otorhinolaryngology, Civil Service Hospital, Minbhawan, Kathmandu, Nepal
| | - Ajit Nepal
- Department of Otorhinolaryngology, Patan Academy of Health Sciences, School of Medicine, Lagankhel, Lalitpur, Nepal
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Impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes: a retrospective analysis in patients with tympanic membrane perforation due to chronic otitis media. The Journal of Laryngology & Otology 2019; 133:1068-1073. [PMID: 31735178 DOI: 10.1017/s0022215119002391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes. METHODS Patients who underwent tympanoplasty type 1 surgery were randomised into temporal fascia graft alone (n = 55) and temporal fascia graft plus platelet-rich fibrin therapy (n = 36) groups. Graft survival and hearing outcomes were recorded. RESULTS Graft survival rates were significantly higher in the temporal fascia graft plus platelet-rich fibrin therapy group than in the temporal fascia graft alone group at one (100.0 vs 85.5 per cent, p = 0.020), three (97.2 vs 80.0 per cent, p = 0.024) and six months post-operatively (94.4 vs 74.5 per cent, p = 0.031). The difference in hearing gain between groups was not significant. CONCLUSION Our findings revealed that the use of a platelet-rich fibrin plus temporal fascia graft for type 1 tympanoplasty was associated with more favourable post-operative outcomes than the use of temporal fascia alone, both in terms of tympanic membrane healing and graft survival; hearing restoration outcomes were similar.
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Asghari A, Mohseni M, Daneshi A, Nasoori Y, Rostami S, Balali M. Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation. Int J Otolaryngol 2018; 2018:2431023. [PMID: 29951098 PMCID: PMC5987340 DOI: 10.1155/2018/2431023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/01/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The purpose of the study is to compare the clinical outcome of the two techniques of Bucket Handle Tympanoplasty and Cartilage Tympanoplasty in achieving success in graft survival as well as acceptable auditory results. 60 patients who suffered chronic otitis media with anterior perforation of the tympanic membrane were chosen. The patients were randomly assigned using Block Randomization Method of two groups including patients who underwent Bucket Handle Tympanoplasty (n = 30) or those that underwent Cartilage Tympanoplasty (n = 30). The patients were followed up for 1, 3, 6, and 12 months postoperatively. RESULTS The mean PTA was lower in Bucket Handle Tympanoplasty group as case group compared to Cartilage Tympanoplasty group as the control (P = 0.023). No significant statistical differences had identified passing through the time, in terms of PTA outcome (P Value = 0.547) and SRT outcome (P Value = 0.352), between Bucket Handle Tympanoplasty group and the Cartilage Tympanoplasty group. In total, postoperative tympanic membrane perforation was found in 10.0% of patients in Cartilage Tympanoplasty group and 13.3% in Bucket Handle Tympanoplasty group with no difference (P = 0.500). CONCLUSIONS Hearing improvements in both methods were similar. REGISTRATION NUMBER The trial is registered with IRCT2016022626773N1.
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Affiliation(s)
- Alimohamad Asghari
- Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohseni
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ahmad Daneshi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Yasser Nasoori
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sara Rostami
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Maryam Balali
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
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