Nithya R, Gangani Hitesh M, Aiyer R G, Gupta Rahul R
CMC, Vellore, India.
Department of ENT & Head-Neck Surgery, Medical College Baroda, S.S.G. Hospital, Vadodara, 390001 India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):246-251. doi: 10.1007/s12070-020-02037-y. Epub 2020 Aug 10.
Chronic suppurative otitis media (CSOM) is one of the important health problems in our country. The present study was conducted to compare Cartilage and Temporalis Fascia as graft material for Type 1 Tympanoplasty for CSOM. The study was conducted to assess hearing outcome as average AB Gap closure respect to age of the patient and size of perforation, to evaluate Graft uptake with both grafting material and with respect to size of perforation and to find the complication rate. Prospective Comparative study was conducted on 60 patients of CSOM divided in two groups and randomly selected for cartilage Typanoplasty and Temporalis Fascia Tympanoplasty. Hearing result are compared pre and post operative. Group 1(cartilage): Average AB Gap closure was 55% for Small CP, 50% for Moderate CP, 40% for Large CP, 38% for Subtotal CP. In Group 2(Temoralis Fascia): Average AB Gap closure was 81% for Small CP, 72% for Moderate CP, 64% for Large CP, 52% for Subtotal CP. In Group 1, 46% and in Group 2, 69% Average closure of AB gap observed at 12 weeks post operatively. The p value for our study was found to be < 0.05, which statistically indicates better hearing outcome with TF graft. Cartilage is an excellent grafting material because of its accessibility, resistance to negative pressure and high graft uptake rate. Temporalis Fascia is easily available with similar thickness to TM. It showed inferior morphological uptake rate compared to cartilage though functional gain was better.
慢性化脓性中耳炎（CSOM）是我国重要的健康问题之一。本研究旨在比较软骨和颞肌筋膜作为CSOM一期鼓室成形术的移植材料。该研究旨在评估听力结果，即根据患者年龄和穿孔大小计算平均气骨导差缩小情况，评估两种移植材料的移植物吸收率以及与穿孔大小的关系，并找出并发症发生率。对60例CSOM患者进行了前瞻性对照研究，将其分为两组，随机选择进行软骨鼓室成形术和颞肌筋膜鼓室成形术。比较术前和术后的听力结果。第1组（软骨组）：小穿孔患者平均气骨导差缩小55%，中等穿孔患者为50%，大穿孔患者为40%，全穿孔患者为38%。第2组（颞肌筋膜组）：小穿孔患者平均气骨导差缩小81%，中等穿孔患者为72%，大穿孔患者为64%，全穿孔患者为52%。术后12周，第1组平均气骨导差缩小46%，第2组为69%。本研究的p值<0.05，从统计学上表明颞肌筋膜移植的听力结果更好。软骨因其易于获取、抗负压能力强和移植物吸收率高，是一种优良的移植材料。颞肌筋膜易于获取，厚度与鼓膜相似。虽然功能改善较好，但其形态学上的移植物吸收率低于软骨。
