THREE-MONTH OUTCOMES OF ENDOSCOPIC TYPE I TYMPANOPLASTY USING TRAGAL CARTILAGE-PERICHONDRIUM GRAFT WITHOUT MIDDLE-EAR GELFOAM PACKING
Main Article Content
Abstract
Background: The role of middle-ear Gelfoam packing in type I tympanoplasty remains debated.
Objective: To evaluate the 3-month outcomes of endoscopic type I tympanoplasty using tragal cartilage-perichondrium graft without middle-ear Gelfoam packing.
Methods: This descriptive clinical case series with prospective follow-up included 20 patients with chronic otitis media and tympanic membrane perforation who underwent endoscopic type I tympanoplasty using a modified underlay tragal cartilage-perichondrium graft at Nhan Dan Gia Dinh Hospital from February to August 2021. Gelfoam was not placed in the middle ear; it was used only lateral to the tympanic membrane and in the external auditory canal. Mean ABG was calculated at 500, 1000 and 2000 Hz.
Results: Mean age was 47.25 ± 11.03 years, and 70% were female. Mean operative time was 43.75 ± 19.9 minutes. No postoperative facial nerve palsy, bleeding, or infection requiring additional treatment was recorded. The graft take rate was 100% at 1 month and 90% at 2 and 3 months. Both cases with loss of tympanic membrane closure occurred in subtotal perforations. Mean ABG decreased from 17.8 ± 4.7 dB preoperatively to 8.6 ± 4.3 dB at 3 months; mean ABG improvement was 9.25 ± 1.6 dB.
Conclusion: In selected patients, this procedure showed a 90% tympanic membrane closure rate and ABG improvement at 3 months. Controlled studies with longer follow-up are needed.
Keywords
endoscopic type I tympanoplasty, tragal cartilage, perichondrium, Gelfoam, chronic otitis media, air-bone gap
Article Details
References
2. Akyigit A, Sakallioglu O, Karlidag T. Endoscopic tympanoplasty. J Otol. 2017;12(2):62-67.
3. Albazee E, Abu-Zaid A, Alshammari B, Salamah M, Alolaywi AN, Almobarak AA, et al. Efficacy of gelfoam middle ear packing in type-1 tympanoplasty: systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2023;280(8):3503-3514.
4. Hellström S, Salén B, Stenfors LE. Absorbable gelatin sponge (Gelfoam) in otosurgery: one cause of undesirable postoperative results? Acta Otolaryngol. 1983;96(3-4):269-275.
5. Sahoo SR, Tripathi J, Kumari S, Rastogi S. Efficacy of middle-ear packing in success of type 1 tympanoplasty: a prospective randomised study. J Laryngol Otol. 2021;135(10):864-868.
6. Shrestha BL, Shrestha A, KC AK. Outcome of endoscopic myringoplasty using Gelfoam versus no Gelfoam in tympanic cavity and external auditory canal. Kathmandu Univ Med J (KUMJ). 2024;22(85):93-98.
7. Wang D, Ren T, Wang W. The outcomes of endoscopic myringoplasty: packing with gelatin sponge versus packing with nothing. Acta Otolaryngol. 2020;140(4):292-296.
8. Yang T, Wu X, Peng X, Zhang Y, Xie S, Sun H. Comparison of cartilage graft and fascia in type 1 tympanoplasty: systematic review and meta-analysis. Acta Otolaryngol. 2016;136(11):1085-1090.