Audiometric evaluation of type 1 tympanoplasty for hearing results

Authors

  • Mallikarjun S. Tegnoor Department of ENT, MRMC/BTGH, Gulbarga, Karnataka, India
  • Kazim Ali Department of ENT, MRMC/BTGH, Gulbarga, Karnataka, India
  • Sutrave Mithun Department of ENT, MRMC/BTGH, Gulbarga, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20171188

Keywords:

Type 1 tympanoplasty, Graft uptake rate, PTA, Hearing improvement

Abstract

Background: To evaluate the graft uptake rate of the type1 tympanoplasty performed by underlay technique using autologous temporalis fascia graft for the last two years and to assess the hearing improvement in the successfully operated cases with respect to age, sex, size and location of perforation.

Methods: This prospective Study included 50 patients, who underwent type1tympanoplasty.All operations are performed using an underlay technique and by postural approach. In all the cases, temporalis fascia is used for the reconstruction of TM. The data of all the patients regarding preoperative disease, perforation size and location, surgical approach, graft material, pre and postoperative clinical and functional (hearing evaluation by pure-tone audiogram) results are analyzed.  

Results: Successful closure rate of the TM perforation is 88% and the graft failure rate is 12%. In this study, lowest and highest age of patients at presentation is 13 and 55 years respectively with a mean age of 26.6 years. Most common approaches is post aural. The mean pre and post-operative air conduction threshold in the successful cases are 33.34 dB and 20.20 dB respectively with a mean audiological improvement of around 13 dB. The improvement in the hearing is achieved in only 88% (44 out of 50) among the successful operated type 1 tympanoplasty.

Conclusions: Type 1 tympanoplasty is a safe and effective technique to improve the quality of life of patients. The most common approach is postural. The graft uptake rate is better at three months. The improvement in hearing is noted irrespective of age, sex, size and location of perforation.

References

Ludman H. Reconstruction’s of the middle ear. Mawason’s Diseases of the ear. 6th edition. Edward Arnold; 1998: 432-433.

Caylan R, Titiz A, Falcioni M, De Donato G, Russo A, Taibah AA, et al. Myringoplasty in Children: Factors influencing surgical outcome. Otolaryngol Head Neck Surg. 1998;118:709-13.

Ludman H. Applied anatomy. Mawson’s Diseases of the Ear. 5th edition. London, Edward Arnold; 1988: 17-25.

Gray RF, Hawthorne M. Synopsis of Otolaryngology. 5th edition. Butterworth-Heinemann; 1992: 3-117.

Anthony WP. Harrison CM. Tympanic membrane perforation: Effect on audiogram. Arch Otolaryngology. 1972;95:506-10.

Adkins WY, White B. Type 1 tympanoplasty: influencing factors. Laryngoscope. 1984;94(7):916-8.

Vartiainen E. Succes and pitfalls in Myringoplasty. The Am J Otol. 1996;14(3):145-8.

Hamans EP. Govaerts PJ, Somers T, Offeciers FE. Allograft tympanoplasty type1 in the childhood population. Ann Otol Rhinol Laryngol. 1996;105(2):871-6.

Lee P, Kelly G, Mills RP. Myringoplasty. Does the size of perforation matter? Clin Otolaryngol All Sci. 2002;27:331-4.

Palva T, Ramsay H. Myringoplasty and tympanoplasty-results related to training and experience. Clin Otolaryngol All Sci. 1995;20:329-35.

Tai CF, Ho KY, Juan KH. Age and prognosis of tympanoplasty type 1. Kaohsiung J Med Sci. 1998;14(9):542-7.

Karela M, Berry S, Watkins A, Phillipps JJ. Myringoplasty: Surgical Outcomes and Hearing Improvement: Is it worth performing to improve Hearing? Eur Arch Otorhinolaryngol. 2008;265:1039-42.

Delbridge L, Reeve TS, Khadra M, Poole AG. Total thyoidectomy: the technique of capsular dissection. Austr N Z J Surg. 1992;62(2):96-9.

Downloads

Published

2017-03-25

Issue

Section

Original Research Articles