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Inicio Acta Otorrinolaringológica Española Island cartilage vs temporalis fascia in type 1 tympanoplasty: A prospective stu...
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Vol. 69. Issue 6.
Pages 311-317 (November - December 2018)
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Vol. 69. Issue 6.
Pages 311-317 (November - December 2018)
Original article
Island cartilage vs temporalis fascia in type 1 tympanoplasty: A prospective study
Cartílago en isla vs. fascia de músculo temporal en timpanoplastia tipo 1: un estudio prospectivo
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Avani Jaina,
Corresponding author
avanijain87@hotmail.com

Corresponding author.
, Sunil Samdanib, Man Prakash Sharmab, Vinod Meenac
a Department of ENT, Lok Nayak Hospital, New Delhi, India
b Department of ENT, Sawai Man Singh Medical College and attached group of hospitals, Jaipur, Rajasthan, India
c District Hospital, Dausa, Rajasthan, India
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Tables (5)
Table 1. Demographic characteristics and graft take up results in our study.
Table 2. Comparison of pre- and post-operative average air conduction threshold and air-bone gap using temporalis fascia graft and island cartilage graft in our study.
Table 3. Graft take up results in various studies.
Table 4. Retraction of neotympanum in various studies.
Table 5. Comparison of air-bone gap closure between temporalis fascia graft and island cartilage graft in various studies.
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Abstract
Objective

(1) To compare the results of graft take-up and audiological outcome of temporalis fascia versus island cartilage graft in type 1 tympanoplasty. (2) To compare the rate of postoperative retraction of neotympanum in both.

Methods

A prospective study was conducted on 70 patients of ages ranging from 11 to 50 years with dry subtotal perforation. 35 underwent island cartilage tympanoplasty and 35 underwent type 1 tympanoplasty using temporalis fascia graft. Graft acceptance rates and post-operative audiograms were compared.

Results

At one year follow up, the graft take-up rate for temporalis fascia and island cartilage graft were found to be 82.9% and 97.1% respectively, which was found to be statistically significant (p<0.05). In the temporalis fascia group, two out of 35 patients (5.7%) had retraction of the neo tympanum. There was no incidence of retraction using island cartilage graft. There was no significant difference in the postoperative air-bone gap gain between temporalis fascia graft and island cartilage graft.

Conclusion

Island cartilage tympanoplasty shows a high degree of reliability in high risk cases. It has a higher graft take-up rate with no incidence of retraction of neotympanum. Moreover, it provided significant hearing improvement in our patients.

Keywords:
Cartilage
Temporalis fascia
Tympanoplasty
Resumen
Objetivo

1) Comparar los resultados del injerto y el resultado audiológico de la fascia del músculo temporal versus injerto de cartílago en isla en la timpanoplastia tipo 1, y 2) Comparar la tasa de retracción postoperatoria del neotímpano en ambos.

Métodos

Se realizó un estudio prospectivo en 70 pacientes de edades comprendidas entre los 11 y 50 años con perforación subtotal en seco. En 35 de ellos se realizó timpanoplastia con cartílago en isla y a los 35 restantes timpanoplastia tipo 1 mediante injerto de fascia de músculo temporal. Se compararon las tasas de aceptación del injerto y los audiogramas postoperatorios.

Resultados

Al año de seguimiento, la tasa de toma del injerto de fascia de músculo temporal y el injerto de cartílago en isla fue del 82,9 y 97,1%, respectivamente, que resultó estadísticamente significativa (p<0,05). En el grupo de fascia de músculo temporal, 2 de 35 pacientes (5,7%) tuvieron una retracción del neotímpano. No hubo incidencia de retracción en el injerto de cartílago en isla. No hubo diferencia significativa en cuanto a la ganancia en el umbral diferencial de audición entre los injertos de fascia de músculo temporal y cartílago en isla.

Conclusión

La timpanoplastia con cartílago en isla muestra un alto grado de fiabilidad en casos de alto riesgo. Tiene una mayor tasa de aceptación del injerto, sin incidencias de retracción del neotímpano. Además, aportó una importante mejora de audición a nuestros pacientes.

Palabras clave:
Cartílago
Fascia de músculo temporal
Timpanoplastia

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