CARTILAGE REINFORCEMENT GRAFT VERSUS TEMPORALIS FASCIA GRAFT IN TYMPANOPLASTY- RANDOMIZED CONTROL TRIAL

Introduction:Because of its healing and acoustic qualities,temporalis fascia has long been thought to be the best graft material for tympanic perforation.A range of materials were employed,including fascia lata,veingraft,dura,temporalis fascia,tragal cartilage, chonchal perichondrium,periostium,and fatty tissue from the ear lobule.These parameters are met by membrane grafts such as perichondrium and temporalis fascia,which close tympanic membrane perforations in 95% of ears with normal ventilation.In this work,we have examined the acoustic characteristics and grafting capabilities of temporal fascia in relation to cartilage reinforcement tympanoplasty, particularly in ears that have central perforations. Materials and methods: Patients who underwent Tympanoplasty with/without ossiculoplasty were reviewed prospectively.The patients were divided into those grafted with Temporalis Fascia alone (Group A) and with temporalis fascia reinforced with cartilage (Group B).In cartilage group ,chonchal, tragal, cymbal cartilage was used with underlay technique together with temporalis fascia as a part of reinforcement technique. Results: In instances undergoing cartilage reinforcement tympanoplasty, the overall graft take up rate was 100%, while in patients undergoing temporalis fascia graft tympanoplasty, it was 95.5%. Patients who had Cartilage Reinforcement Tympanoplasty experienced a notable improvement in their hearing. Conclusion:-. Thus, tragal perichondrium cartilage should be taken into consideration as a viable temporalis fascia substitute. Using cartilage that is the right thickness appears to be the key. This would prevent the neo tympanum from retracting or reperforating without impairing sound conduction.A robust graft material with good revascularization is perichondrium.Negative middle ear pressure would be countered by the composite of cartilage and perichondrium. This is crucial in cases of extensive perforations in the ears and poor eustachian tube function.