Abstract

Chronic otitis media(COM) is an inflammatory process of the middle ear space that results in long term or more often, permanent changes in the tympanic membrane (TM) which includes atelectasis, dimer formation, perforation, tympanosclerosis, retraction pocket formation or cholesteatoma formation. With the advent of antibiotics, modern anaesthetic techniques and modern instruments, the aim is to produce a dry ear and it has changed the outcomes of the surgery drastically. Aim: To conduct a retrospective comparative analysis to evaluate the long-term postoperative results of tragal perichondrium and temporalis fascia grafts by analyzing the anatomic-auditory outcomes. Methods and Material: A retrospective study was performed in the Department of Otorhinolaryngology on patients diagnosed with COM and underlay type 1 tympanoplasty was done from September 19, 2022 to September 19, 2023. A detailed history and clinical examination of the patients of chronic otitis media was done and case selection was done randomly after satisfaction of inclusion and exclusion criteria. The cases were subjected to microscopic examination and pre-operative audiological test (pure tone audiometry) was performed in each case. Underlay Type 1 tympanoplasty was done using tragal perichondrium and temporalis fascia graft and postoperative follow up was done Results: Majority of the selected patients showed mild to moderate hearing loss preoperatively. At 3 months postoperative 90% and 85% operated with temporalis fascia and tragal cartilage perichondrium respectively as a graft showed improvement in hearing. Graft uptake was seen in 85% and 80% of patients who underwent surgery with tragal cartilage perichondrium and temporalis fascia as graft respectively at the end of 3 months. Graft failure was seen in 15% and 20% of cases who underwent surgery with tragal cartilage perichondrium and temporalis fascia respectively at the end of 3 months. Conclusion: Temporalis fascia and Tragal cartilage perichondrium both are excellent graft material to repair the tympanic membrane. Graft uptake rate and hearing improvement were comparable in both grafts but hearing improvement was slightly better in case of temporalis fascia graft and graft uptake rate was slightly better in case of Tragal cartilage perichondrium graft.

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