Published: 2021-05-26

Pre-operative and post-operative audiological evaluation of type 1 tympanoplasty and comparison between temporalis fascia graft and tragal perichondrium graft

Satguru Saran Singh, Sandip M. Parmar, Abhey Sood, Nilank Saroha, Meenu Chaudhary


Background: Aim of the study was to evaluate the hearing improvement of type 1 tympanoplasty performed by using autologous temporalis fascia and autologous tragal perichondrium graft in successfully operated and graft uptake cases, with respect to age, sex, size of perforation and type of graft.

Methods: This prospective study consists of total 100 patients with chronic suppurative otitis media (CSOM) tubotympanic disease who have undergone type 1 tympanoplasty. Randomization of patients was done. Every alternate patient was divided accordingly in to two groups-one in temporalis fascia graft group and another in tragal perichondrium graft group. Pure tone audiometry (PTA) was performed preoperatively and 3 months after surgery. Cases with successful graft uptake were included in the study. Statistical comparisons were performed using the t test, and ANOVA test.

Results: In this study maximum numbers of patients were found in the age group of 15-30 years. Study showed that audiological benefits were more in males in comparison to females. Large size of perforation showed more improvement due to more air bone gap in comparison to medium size and small size perforation of ears. Audiological improvement occurred in 94% of cases, 3% cases worsened and 3% cases showed no change. More improvement was found in temporalis fascia graft in comparison to tragal perichondrium graft.

Conclusions: Type 1 tympanoplasty is a safe and effective technique to improve the quality of life of patients. Size of perforation, type of graft was found to have a major effect on the final outcome of surgery.


CSOM, Type 1 tympanoplasty, PTA, Hearing improvement

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Wasson JD, Papadimitriou CE, Pau H. Myringoplasty: closure and audiological improvement impact of perforation size. J Laryngol Otol. 2009;123(9):973-7.

Perkins R. Grafting materials in reconstructive ear surgery and methods. Ann Sep Otol Rhinol Laryngol. 1975;84(4 Pt 1):518-26.

Kelly G, Lee P, Mills RP. Myringoplasty: does it matter what size the perforation is Clin Otolaryngol Allied Sci. 2002;27(5):331-4.

Gibb AG, Chang SK. Myringoplasty (A 365 operations review). J Laryngol Otol. 1982; 96(10):915-30.

Yung MW-Myringoplasty: hearing gain relative to the site of perforation. Laryngol Otol J. 1983;97(1):11-77.

James L, Sheehy, Anderson RG. Myringoplasty. A review of 472 cases. Ann Otol Rhinol Laryngol. 1980;89(4 Pt 1):331-4.

Packer P. What’s best in Myringoplasty: Underlay or Overlay, dura or fascia? Laryngol Otol J. 1982;96:25-41.

Bawa GS, Khurana AS, Singh H. Comparative evaluation of Auto graft Temporalis fascia and Homograft duramaterin Tympanoplasty. Indian J Otolaryngol. 1987;39(3):102-3.

Vartiainen E, Nuutinen J. Success and pitfalls in myringoplasty: follow-up study of 404 cases. Am J Otol. 1993;14(3):301-5.

Al-Ghamdi SA. Tympanoplasty: Factors that influence the outcome of surgery. Ann Saudi Med. 1994;14(6):483-5.

Sai Kiran G, Krishna VC. A Prospective Observational Study of Temporalis Fascia with Tragal Perichondrium as Graft Material in Type I Tympanoplasty. Int J Sci Res. 2019;8(12):509-31.