Abstract

Temporalis fascia which is placed as an underlay graft is commonly used to repair tympanic membrane perforations. Graft failure is a well recognized complication. Aim: A total of 100 cases were selected based upon inclusion criteria for this study, which is done to know the effectiveness of temporalis fascia as graft material for myringoplasty and also to know the hearing gain following this procedure. Materials and Methods: The present study was conducted from the patients attending the outpatient department of E.N.T., Alluri Sita Rama Raju Academy of Medical Sciences from the month of August, 2010 to March, 2012. Patients between 18-48 years of age presenting with chronic suppurative otitis media, tubotympanic disease whose ear is dry for last 4 weeks and post operatively patient is followed till 6 months were the inclusion criteria. Results: This is a hospital based prospective study. Of the 100 cases, the age group of the patient varied from 18 to 48 years. There was no correlation between graft take rate and age. There were 58 females and 42 males.70 cases belonged to lower socio-economic strata and 30 cases belonged to middle income group. Bilateral chronic suppurative otitis media was seen in 27 cases. 34cases in our study had perforation of more than 50% in size, in which the graft take up rate was very poor. Site of perforation did not have much effect on the outcome of graft status. The preoperative pure tone average mean in our study was 31.85 dB and postoperative pure tone average mean was 16.10 dB, thus the hearing gain was 15.75 dB. The overall success rate of graft take up in our study is 87%, while 60 of them had hearing improvement of 10 to 20 dB, also hearing improvement of more than 20dB in 27 patients and improvement was less than 10dB in 13 patients. The most common cause for graft failure in our study was postoperative infection, the other cause being faulty technique of operation, Eustachian tube dysfunction. Conclusion: The study concluded that the outcome of myringoplasty does not depend on age and sex. Tympanic membrane with perforation of more than 50% have poor take up rates. Site of perforation did not have relevance with graft take up. There is a mean hearing gain of 15.75 dB in patients who had undergone myringoplasty with graft taken up. Postoperative infection, Eustachian tube dysfunction and faulty technique are the common reasons for graft failure.

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