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A comparative study to assess the graft uptake in patients undergoing postauricular tympanoplasty using temporalis fascia vs sliced tragal cartilage

Tejal Arun Sonar, Rishikesh Dilip Pawar, Vinod Shinde, Mayur Ingale, Anuja Satav, Shikha Paresh Shah.

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Tympanoplasty is a surgical procedure to repair tympanic membrane perforation and reconstruct the tympanic membrane and hearing, commonly done after chronic suppurative otitis media and trauma.
Aims: To comparatively study the graft uptake in patients undergoing type 1 tympanoplasty using temporalis fascia vs sliced tragal cartilage
Settings and Design:
The study was a prospective case-control study carried out in the department of ENT, D.Y.Patil medical college, Pimpri
Methods and Material:
Fifty patients undergoing tympanoplasty were randomly divided into 2 groups and operated on using Temporalis fascia(TF) in 25 patients and Sliced tragal cartilage(STC) graft in the rest 25 patients. All cases were operated on under local anaesthesia. A post-aural approach was implemented for the surgery. Twenty-five patients were subjected to tympanic membrane repair with temporalis fascia graft and the remaining 25 with Tragal cartilage graft. For tragal cartilage, a graft incision was taken over the undersurface of the tragus, and the obtained tragal cartilage was sliced to a thickness of 0.5 to 1.0 mm.
The mean duration of symptoms was 12.72 and 15.84 months in groups A and B respectively. A successful graft uptake was noted in 21(84%) patients in the TF group whereas it was noted in 24 patients in the STC group (96%). Permanent perforation was noted in 4 (16%) patients in the TF group and 1 (4%) in the STC group. The difference was non-significant, with a P-value of 0.157
In the clinical study performed, postauricular tympanoplasty using the Sliced tragal cartilage was associated with better graft uptake and hence can be regularly employed for tympanic membrane repair compared to Temporalis fascia.

Key words: tympanoplasty, Tragal Cartilage, Temporalis Fascia, Tympanic Membrane, graft uptake

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