Surgical and Audiological Outcomes of Wet Versus Dry Temporalis Fascia Graft in Type 1 Tympanoplasty

Authors

  • Hemn Hussain Othman College of Medicine, Sulaimanyah University, Sulimanyah, Iraq.
  • Hiwa Asaad Abdulkareem College of Medicine, Sulaimanyah University, Sulimanyah, Iraq.

DOI:

https://doi.org/10.22317/imj.v7i3.1251

Abstract

Objectives: Evaluate the surgical success and postoperative hearing outcome of type 1 tympanoplasty using temporalis fascia graft in its wet versus its dry fashion.

Methods: A prospective randomized comparative study which was conducted in Sulaimanyah otorhinolaryngology & head and neck surgery centre between October 2018 and November 2019  on patients with sign and symptom of tympanic membrane perforation who underwent type1 tympanoplasty in 2 groups in whom wet graft used in one group, and dry graft used in the other group, these patient followed up after 3 month for graft take and postoperative hearing.

Results: Of the 29 patients included in the study in 15 of them dry graft used and the graft take was 86.7% and in 14 of the wet graft used and the take rate was78.6%, postoperative mean hearing gain was 14.07 dB in the dry graft group and 12 dB in the wet graft group, all cases in both group had improvement in hearing (P value= 0.001), but neither wet nor dry was better than the other (P value=0.345). Graft take and hearing gain in different site and size of perforations were not significant, graft take rate was 100% in small size and 50% in subtotal perforation, hearing gain was 14.50 dB for subtotal perforation and 9.50 dB in small size perforation, mean time of wet graft group with 75.36 minutes were shorter significantly than the dry graft with 95 minutes with (P value=0.001).

Conclusion: The Nature of the temporalis fascia not affect the outcome type 1 tympanoplasty, and temporalis fascia is a good graft material regarding the success rate and hearing gain, however the wet Temporalis fascia graft use may shorten the operation time.

References

Francis HW. Anatomy of the Temporal bone. External Ear and Middle Ear. Cummings Otorhinolaryngology-Head and Neck Surgery. 6th edition. Philadelphia: Elsevier Saunders; 2015. p1977–86.

Athanasiadis A, Sismanis. Tympanoplasty: Tympanic Membrane Repair. Glasscock-Shambaugh Surgery of the EAR. 6th edition. Connecticut: People’s Medical Publishing House; 2010. page 468–88.

Huins C, lavy J. Myringoplasty. Scott-Brown’s Otorhinolaryngology-Head and Neck Surgery. 8th edition. London: CRC Press; 2018. p.1021–1027.

Sheehy JL, Anderson RG. Myringoplasty: a review of 472 cases. Annals of Otology, Rhinology & Laryngology. 1980 Jul; 89(4):331–4.

Kaylie DM, Jackson C.G, Glasscock ME, Strasnick B. Tympanoplasty- Undersurface Graft Technique: Postauricular Approach. Otologic Surgery 4th edition Philadelphia: Elsevier; 2016. p.123–33.

Adams ME, El-Kashlan HK. Tympanoplsty and Ossiculoplasty. Cummings Otorhinolaryngology-Head and Neck Surgery. 6th edition. Philadelphia: Elsevier Saunders; 2015. p: 2177–187.

Jiang Z, Lou Z. Impact of the nature of the temporalis fascia graft on the outcome of type I underlay tympanoplasty. The Journal of Laryngology & Otology. 2017 Jun;131(6):472–5.

Alkan S, Baylançiçek S, Sözen E, Başak T, Dadaş B. Effect of the use of dry (rigid) or wet (soft) temporal fascia graft on tympanoplasty. Journal of Otolaryngology-Head & Neck Surgery. 2009 Feb 1;38(1).

Loock JW, Naude N. A randomised controlled trial comparing fresh, dried, and dried‐then‐rehydrated temporalis fascia in myringoplasty. Clinical Otolaryngology. 2008 Apr;33(2):97–101.

Fisch U, May J, Linder T. Mastoidectomy and stapes surgery. Stuttgart: Thieme, 2007.

Shenoi PM. Autogenous temporalis fascia grafts: detailed light and electron microscopical observations on the effects of preparations. The Journal of Laryngology & Otology. 1982 Sep;96(9):801–10.

Walby AP, Kerr AG, Nevin NC, Woods G. Tissue culture of surgically prepared temporalis fascia. Clinical Otolaryngology & Allied Sciences. 1982 Oct;7(5):313–7.

Singh GB, Kumar D, Aggarwal K, Garg S, Arora R, Kumar S. Tympanoplasty: does dry or wet temporalis fascia graft matter?. The Journal of Laryngology & Otology. 2016 Aug;130(8):700–5.

England RJ, Strachan DR, Buckley JG. Temporalis fascia grafts shrink. The Journal of Laryngology & Otology. 1997 Aug;111(8):707–8.

Wormald PJ, Alun-Jones T. Anatomy of the temporalis fascia. The Journal of Laryngology & Otology. 1991 Jul;105(7):522–4.

Indorewala S. Dimensional stability of free fascia grafts: clinical application. The Laryngoscope. 2005 Feb;115(2):278–82.

Chow LC, Hui Y, Wei WI. Permeatal temporalis fascia graft harvesting for minimally invasive myringoplasty. The Laryngoscope. 2004 Feb;114(2):386–8.

Emir H, Ceylan K, Kizilkaya Z, Gocmen H, Uzunkulaoglu H, Samim E. Success is a matter of experience: type 1 tympanoplasty. European archives of oto-rhinolaryngology. 2007 Jun 1;264(6):595–9.

Black JH, Wormald PJ. Myringoplasty-effects on hearing and contributing factors. South African medical journal. 1995;85(1):41–3.

de Lima JC, Marone SA, Martucci O, Gonçalez F, da Silva Neto JJ, Ramos AC. Evaluation of the organic and functional results of tympanoplasties through a retroauricular approach at a medical residency unit. Brazilian journalof otorhinolaryngology. 2011 Mar 1;77(2):229–36.

Naderpour M, Moghadam YJ, Ghanbarpour E, Shahidi N. Evaluation of factors affecting the surgical outcome in tympanoplasty. Iranian journal of otorhinolaryngology. 2016 Mar;28(85):99.

Yung MW. Myringoplasty for subtotal perforation. Clinical Otolaryngology & Allied Sciences. 1995 Jun;20(3):241–5.

Applebaum EL, Deutsch EC. An endoscopic method of tympanic membrane fluorescein angiography. Annals of Otology, Rhinology &

Laryngology. 1986 Sep;95(5):439–43.

Karela M, Berry S, Watkins A, Phillipps JJ. Myringoplasty: surgical outcomesand hearing improvement: is it worth performing to improve hearing?. European archives of oto-rhino-laryngology. 2008 Sep 1;265(9):1039–42.

Yung MW. Myringoplasty: hearing gain in relation to perforation site. The Journal of Laryngology & Otology. 1983 Jan;97(1):11–7.

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Published

2023-10-29

How to Cite

1.
Hussain Othman H, Asaad Abdulkareem H. Surgical and Audiological Outcomes of Wet Versus Dry Temporalis Fascia Graft in Type 1 Tympanoplasty. Iraq Med J [Internet]. 2023 Oct. 29 [cited 2024 Nov. 25];7(3). Available from: https://mail.iraqmedj.org/index.php/imj/article/view/1251

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