Indra Thirugnanam1, M. K. Rajasekar2
BACKGROUND
Though single sitting myringoplasty using temporalis fascia under general anaesthesia has been documented in many studies, but ours is the first center to have started using tragal cartilage and temporalis fascia harvested from one ear to do bilateral myringoplasty in one sitting using local anaesthesia with excellent results including very good graft uptake rate and audiological improvement without significant complications.
The aim of the study is to compare the outcome of bilateral myringoplasty in dry central perforation in one sitting using cartilage on one side and temporalis fascia on the other ear in an urban tertiary care centre.
MATERIALS AND METHODS
A total of 50 patients above the age of 15 years were included in the study who had dried bilateral perforated ear drum involving pars tensa both sides size of perforation and hearing loss were more or less-matched patients who had persistently discharging ear or had evidence of middle ear infection, granulation tissues, aural polypi, cholesteatoma, ossicular erosion or evidence of sensorineural hearing loss were excluded from the study. In the cases, temporalis fascia graft through postaural incision right side and conchal cartilage was harvested from the right side and endoscopic myringoplasty was performed. Temporalis fascia graft placed by underlay technique and conchal cartilage was used as graft on the left side for all the patients. Patients were followed up after 3 and 6 months to assess closure of tympanic membrane perforation and hearing improvement as depicted by closure of air above gap on pure tone audiometry at 6 months.
Study Design- Interventional, descriptive.
Place and Duration of Study- Department of ENT, UIORL, Madras Medical College and Rajiv Gandhi Government General Hospital, June 2012 to July 2013.
RESULTS
A total of 100 myringoplasties were performed on 50 patients included in the study. Majority of the patients included were having medium to large size perforation. Subtotal perforation was noted in 15 ears and only 5 ears were having small perforation. Successful closure of anatomic defect of tympanic membrane was achieved in 90 ears with an average hearing gain of 16 dB.
CONCLUSION
Bilateral myringoplasty is safe and effective procedure in patients with bilateral dry central perforation of tympanic membrane. It may be performed in one sitting with equally good anatomical and functional results as achieved in unilateral myringoplasties.
KEYWORDS
Chronic Suppurative Otitis Media, Myringoplasty, Sensorineural Deafness, Tympanic Membrane Perforation.
