Search

Aim: To study the effect of site and size of tympanic membrane perforation on graft uptake rates and hearing improvement in Type I tympanoplasty using sliced conchal cartilage reinforced with temporalis muscle fascia and temporalis muscle fascia alone. Materials and Methods: In this retrospective study, a total of forty patients presenting with dry central perforation with intact and mobile ossicular chain and conductive type of hearing loss, visiting the ENT outpatient department of Government Medical College, Amritsar, were included. They were randomly divided into two groups of twenty patients each, with Group I patients undergoing Type I tympanoplasty with temporalis muscle fascia and Group II patients with sliced conchal cartilage as graft reinforced with temporalis fascia. A pure-tone audiometry (PTA) was done within 1 week prior to the surgery and at 3 months postoperatively to evaluate the hearing status. Results: Overall graft uptake rate in Group I was 85%, whereas that in Group II was 95% (P < 0.01). In Group I, graft uptake rate for small perforations was 100%, for medium 85.71%, subtotal 80%, and big central 66.66%. However, Group II graft uptake rates were 100% in all sizes except in medium-sized perforations (83.33%). The air-bone gap gain in Groups I and II was 14.91 (standard deviation [SD] ±9.741) and 14.48 (SD ± 9.366), respectively (P > 0.05). The hearing improvement was statistically insignificant between anterior and posterior perforations. Conclusion: From this study, we observed that size of the perforation is a major factor that influences graft uptake and hearing improvement results in Type I tympanoplasty using reinforced sliced conchal cartilage. Site of perforation failed to be a statistically significant influencing factor in this study. [ABSTRACT FROM AUTHOR]