MYRINGOPLASTY: CARTILAGE PALISADES VS TEMPORALIS FASCIA IN LARGE PERFORATIONS

Abstract

Objective:

To compare the graft uptake rate and postoperative hearing results of myringoplasty with cartilage palisades and temporalis fascia in large perforations.

Materials and methods:

Patients of age 13 years and above with diagnosis of chronic otitis media – mucosal type with large perforation that is more than 50% of tympanic membrane were included. Pure Tone Audiometry were done within 1 week before surgery. 61 cases were included for myringoplasty which were randomly allocated by lottery method with 30 cases in cartilage palisades group and 31 cases in temporalis fascia group. Graft uptake results were assessed after 6 weeks and postoperative hearing was evaluated and compared within and between the groups.

Results:

Graft uptake rate in cartilage palisades group was 86.66% and in temporalis fascia group was 90.32% with no significance difference in the graft uptake rate (p = 0.707) between the groups. The mean pre and post-operative air bone gap in cartilage palisades group and temporalis fascia group were 29.26dB ± 10.66, 20.41 ± 10.54dB and 29.52 ± 11.12dB, 17.93 ± 8.83dB, respectively with highly significant difference obtained within the groups (p < 0.001) showing improvement in the hearing after surgery. However, there was no significant difference between the groups (p = 0.384).

Conclusion:

The graft uptake rate and hearing results after cartilage palisades are comparable to those of temporalis fascia in large perforations. Thus cartilage palisades myringolplasty is recommended as an alternative option.

Keywords: Cartilage Palisades, chronic otitis media, Large Perforation, Myringoplasty, Pure tone audiometry, Temporalis Fascia