Comparative Study Between Single Layer and Double Layer Graft Technique in Tympanoplasty for Subtotal Tympanic...

Area of Science:

• Otolaryngology
• Surgical Innovation
• Regenerative Medicine

Background:

• Chronic suppurative otitis media (CSOM) with mucosal type requires tympanoplasty for treatment.
• Subtotal tympanic membrane perforations are common in safe-type CSOM.
• Grafting techniques aim to restore tympanic membrane integrity and hearing.

Purpose of the Study:

• To compare the clinical and audiological outcomes of single-layer versus double-layer tympanoplasty.
• To evaluate graft healing and audiological results (Air Bone Gap) in two distinct grafting methods.
• To determine the efficacy of composite grafts versus combined temporalis fascia and cartilage grafts.

Main Methods:

• A comparative study involving 40 patients with subtotal tympanic membrane perforations.
• Group 1: Single-layer graft (perichondrium with cartilage island).
• Group 2: Double-layer graft (perichondrium/cartilage island composite plus temporalis fascia).

Main Results:

• Double-layer tympanoplasty showed a significant improvement in the mean Air Bone Gap (ABG) post-surgery.
• Significant differences were observed in ABG changes and tympanic membrane healing between the single-layer and double-layer groups.
• The double-layer graft group exhibited superior healing and a lower incidence of residual perforation or graft rejection.

Conclusions:

• Double-layer tympanoplasty, utilizing temporalis fascia and tragal cartilage/perichondrium, significantly enhances tympanic membrane healing.
• This technique leads to a lower risk of residual perforation and graft rejection compared to single-layer grafts.
• The double-graft approach offers considerable improvements in clinical outcomes for tympanoplasty procedures.