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55384

Tympanomeatal Degloving Technique Versus Ring Graft Underlay Technique in Tympanoplasty Type I for Subtotal Perforations

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Last updated: 22 Jan 2023

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Abstract

Abstract
Background: Tympanoplasty is an operative procedure used in the reconstruction of a perforation of the tympanic membrane (TM). Two classic methods for reconstruction of a TM perforation have been used: The underlay or overlay graft techniques. Each of these approaches and techniques has its advantages and disadvantages [1,2,3].
Objectives: The aim of this study was to evaluate the outcomes of tympanoplasty type I performed with overlay temporalis fascia using tympanomeatal degloving technique and to compare them with results of tympanoplasty type I performed with underlay ring graft [modified cartilage peri-chondrium composite graft, CPCG].
Patients and Methods: This study is a comperative pro-spective study carried out in ORL-HNS Department in Tanta University Hospital, operative procedures was done in the period from October 2015 to February 2016 Study followed by 3 month follow-up for each case, population was forty-eight consecutive cases of subtotal TM perforation undergoing type one tympanoplasty.
The patients were divided into 2 surgical groups [I&II], 24 ears each. Group (I) is treated by using tympanomeatal degloving technique & overlay temporalis fascia. While Group (II) is treated by using ring graft underlay technique.
Results: Fascia group showed better hearing results [the change in ABG was (mean: 12.6±5.2) dB] than the Ring group [the change of ABG was (mean: 11.6±3.9) dB] but the differ-ence between both groups is statistically insignificant.
The graft success rate in (group 1) was 83.3%. Only 4 cases (16.7%) developed post operative perforations. In (group II) the success rate was 95.8%. Only one case (4.2%) developed post operative perforation. The difference in the graft success rates between the 2 groups is statistically insignificant (p>0.05)
Conclusion: Both techniques we used in this study were very effective in closing subtotal large perforations of TM. Ring group showed better healing results but the difference between both groups is statistically insignificant (p>0.05).
Fascia group showed better hearing results but the differ-ence between both groups is statistically insignificant.

DOI

10.21608/mjcu.2018.55384

Keywords

Tympanoplasty – Overlay graft – Temporalis fascia graft – Cartilage perichondrium and ring graft

Authors

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AHMED M.M. HESHMAT, M.S.c.;

Last Name

MAHMOUD A.E. HAGRASS, M.D.

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First Name

MOHAMED N.A. EL-SHEIKH, M.D.;

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HASSAN M. HEGAZI, M.D.

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Affiliation

The Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt

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Volume

86

Article Issue

March

Related Issue

8392

Issue Date

2018-03-01

Receive Date

2017-10-26

Publish Date

2018-03-01

Page Start

685

Page End

693

Print ISSN

0045-3803

Online ISSN

2536-9806

Link

https://mjcu.journals.ekb.eg/article_55384.html

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https://mjcu.journals.ekb.eg/service?article_code=55384

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88

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Original Article

Type Code

263

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Journal

Publication Title

The Medical Journal of Cairo University

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https://mjcu.journals.ekb.eg/

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Article

Created At

22 Jan 2023