Surgical outcomes of tragal island cartilage and temporal muscle fascia grafts in tympanoplasty

Abstract

Objective: We aimed to compare the efficacy of temporalis muscle fascia and tragal cartilage island grafts after tympanoplasty in terms of functional hearing outcomes and tympanometric findings. Methods: A total of 42 patients were enrolled in this study and Group 1 including 14 patients was defined as fascia group while Group 2 including 28 patients was defined as tragal cartilage group. After preoperative odiometric and typmpanometric measurements were done, grefts were laid as under-overlay with the same surgical technique. Only patients with intact grafts at the end 6th month of observation period were included in the study. Surgical outcomes were compared with respect to preoperative and postoperative 6th month odiometric and tympanometric findings within and between the two groups. Results: Postoperative pure tone audiometric results were significantly better than preoperative values in both groups (p=0.001 for fascia graft; p0.05) at pure tone audiometric and tympanometric results between fascia and cartialge groups regarding the pre and postoperative tests. Conclusion: Tragal cartilage island graft provides satisfactory outcomes in tympanoplasty in terms of both functional hearing results and resistance against retraction and resorption. However, it must be kept in mind that constriction of middle ear volume after use of tragal cartilage grafts in tympanoplasty is not uncommon.

Keywords

• Tympanoplasty, graft, temporal muscle fascia, tragal cartilage

Timpanoplastide tragal kıkırdak ada ve temporal kas fasya greft sonuçları

Öz

Amaç: Temporal kas fasya grefti ile tragal kıkırdak ada greftinin timpanoplasti sonrası fonksiyonel işitme sonuçları ve timpanometrik bulgular açısından birbiriyle karşılaştırılması. Yöntem: Toplam 42 hasta çalışmaya alınmış olup, Grup 1, 14 hastadan oluşan temporal kas fasya grubu, Grup 2 ise 28 hastadan oluşan tragal kıkırdak grubu olarak belirlendi. Preoperatif odyometrik ve timpanometrik ölçümler yapıldıktan sonra greftler aynı cerrahi teknikle under-overlay olarak serildi. Altı aylık gözlem süresi sonunda sadece grefti intakt olanlar çalışmaya dâhil edildi. Postoperatif 6. ayda odyometrik ve timpanometrik ölçümler yapılarak grup içi ve gruplara arası karşılaştırma yapıldı. Bulgular: Saf ses ortalamaları bakımından aynı grup içinde preoperatif ve postoperatif ölçümlerde anlamlı fark bulundu (Grup 1: p= 0.001; Grup 2: p0.05). Sonuç: Timpanoplastide tragal kıkırdak ada grefti, hem fonksiyonel işitme sonuçlarının temporal kas fasya grefti kadar iyi olmasını sağlamakta, hem de retraksiyon ve rezorpsiyona karşı direnç sağlamaktadır. Öte yandan, tragal kıkırdak grefti kullanılan hastalarda orta kulak hacminde daralmalar olabileceği göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Timpanoplasti, greft, temporal kas fasyası, tragal kıkırdak

Kaynakça

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24. Makalenin atıf künyesi: Mutlu Ö, Okuyucu Ş, Gümüş R, Gözel S. Timpanoplastide tragal kıkırdak ada ve temporal kas fasya greft sonuçları. J Med
25. Updates 2012;2(3):114-119.