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Paediatric Type 1 Tympanoplasty: Comparison of Full Thickness Tragal Cartilage Versus Temporalis Fascia Graft-A
Priti R Dhoke1, Kanchan S Dhote1, Sonali Khadakkar1
1Department of ENT, NKPSIMS & LMH, Nagpur, Maharashtra 440019 India.
Insights
This study found cartilage and temporalis fascia grafts offer similar outcomes for pediatric tympanoplasty regarding graft success and hearing improvement. Both materials are effective for type 1 tympanoplasty in children.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Regenerative Medicine
Background:
- Tympanic membrane perforations in children often result from middle ear infections.
- Type 1 tympanoplasty is a common surgical procedure to repair these perforations.
- Graft material choice impacts surgical outcomes in pediatric tympanoplasty.
Purpose of the Study:
- To compare the anatomical and functional results of cartilage versus temporalis fascia grafts.
- To evaluate graft success rates and hearing outcomes in pediatric patients undergoing type 1 tympanoplasty.
Main Methods:
- A hospital-based randomized controlled trial involving 90 pediatric patients (5-18 years).
- Patients were divided into two groups: cartilage graft (n=45) and temporalis fascia graft (n=45).
- All underwent type 1 tympanoplasty via a post-auricular approach under general anesthesia.
Main Results:
- Graft success rates were 91.1% for cartilage and 84.44% for fascia (p=0.449, not significant).
- Air bone gap closure was marginally better with temporalis fascia, but overall functional success was similar.
- No statistically significant difference in anatomical or functional outcomes between the two graft types.
Conclusions:
- Both cartilage and temporalis fascia grafts provide comparable results for type 1 tympanoplasty in children.
- The choice between cartilage and temporalis fascia may not significantly affect hearing gain or graft success.
- Further research could explore long-term outcomes and patient-specific factors influencing graft choice.
Abstract:
Tympanic membrane perforation in children usually appears as a sequel of middle ear infection. This study was conducted to compare the anatomical and functional outcomes of cartilage and temporalis fascia graft in type 1 tympanoplasty in Paediatric population.
Design:
A hospital based randomized controlled trial.
Setting:
A tertiary care institute of central India.
Subjects:
All consecutive paediatric patients between 5 and 18 years of either sex attending ENT OPD and Paediatric OPD fulfilling inclusion criteria were included in the study. Anatomical and functional results of total 90 patients who underwent tympanoplasty were analyzed. These patients were divided into two groups depending on the graft material used. The cartilage group and the temporalis fascia group each comprising of 45 patients respectively.
Methods:
All patients underwent Type I tympanoplasty under general anaesthesia and with a post auricular approach. The surgeries were performed by senior surgeons. The graft success rate of the cartilage group (91.1%) was higher than the fascia group (84.44%) but the difference was not statistically significant (p = 0.449). The air bone gap closure was slightly better with temporalis fascia group than with cartilage group but the overall functional success rate in both the groups was not statistically significant.Cartilage and fascia grafts yield similar results for hearing gain and graft success rate in paediatric tympanoplasty.
