A Prospective Randomized Study to Compare Surgical Outcome Using Wet and Dry Temporalis Fascia Graft in Type I Tympanoplasty

Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):229-233. doi: 10.1007/s12070-020-02027-0. Epub 2020 Aug 5.

Abstract

Temporalis fascia is being used as graft material for tympanic membrane repair for over six decades. Though cartilage with or without perichondrium is also being used for different situations, still temporalis fascia graft is being considered as an ideal graft for tympanoplasty. Earlier the dried temporalis fascia was used as a graft but now freshly taken wet temporalis fascia is increasingly being used as a more 'physiological/ live' graft. The present study was planned to compare the results of use of wet and dry temporalis fascia in chronic otitis media mucosal disease. The prospective study was conducted on 100 patients of chronic suppurative otitis media mucosal disease. Chronic ear survey questionnaire were filled to note the impact on quality of life. Otoscopic, oto-endoscopic and examination under microscope performed. Patients were allocated into two groups alternately. Freshly taken wet temporalis graft was used in group I whereas dry temporalis fascia was used in group II. Hearing evaluation by pure tone audiogram was done preoperatively and at 6th months post-operatively. Pre-operative and post-operative hearings in both the groups were compared. Air bone gap closures after surgery in between both the groups were compared to see for any statistical difference. We found similar graft uptake in both the groups after 6 months of surgery. The air bone gap closure in group I was 10.80 ± 5.74 and group II was 9.28 ± 4.81, there was no significant difference. However senior authors noted that in some of the cases in group I with fresh wet graft placement neo-tympanum formation was noticed early showing good circumferential leash of blood vessels all around signifying early vascularisation.

Keywords: COM; Chronic otitis media; Temporalis fascia; Wet and dry graft.