Publication: Role of Endoscopic Modified Inlay Butterfly Cartilage Perichondrium Myringoplasty in Hearing Outcome and Graft Uptake
Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The endoscopes have better optics and magnification with wide angle of view due
to angled lenses. It provides the excellent resolution of image in surgeries having
many difficult anatomic nooks and corners like; antero-inferior recess of external
auditory canal, middle ear cavity and difficult areas to visualize under microspore
like sinus tympani. Likewise, the use of cartilage has very low metabolic rate, provide
support to prevent retraction and reacts minimally to inflammatory reaction, so it
has advantageous role in closure of tympanic membrane perforations.
Objective
The main objective of our study is to see the graft uptake rate and hearing results
after endoscopic cartilage myringoplasty with our own modification.
Method
This is a prospective, cohort study conducted among 37 patients who underwent
endoscopic modified inlay butterfly cartilage perichondrium myringoplasty using
tragal cartilage. The hearing was assessed by comparing pre with post-operative ABG
(Air bone gap) and ABG closure in speech frequencies (500Hz, 1KHz, 2KHz, 4KHz).
Result
Among 42 patients, 37 (88.09%) had graft uptaken. Other five patients had residual
perforation because of infection. The post-operative ABG was smaller than pre-
operative ABG.(26.41±8.47dB and 36.57±12.13dB respectively). The mean ABG
closure was 10.15±10.23dB. The ABG closure was ≤ 10dB in 28(75.6%) patients.
Conclusion
Endoscopic modified inlay butterfly cartilage perichondrium myringoplasty has
advantages in terms of hearing results and graft uptake rate as it is comparable or
even better than others. So, it is advisable to perform this technique without any
difficulty.
KEY WORDS
Air bone gap, cartilage, endoscope, myringoplasty
Description
Shrestha BL, Dhakal A, Pradhan A, Rajbhandari P
Department of ENT-HNS,
Dhulikhel Hospital, Kathmandu University Hospital,
Dhulikhel, Kavre, Nepal.
Keywords
Air bone gap, cartilage, endoscope, myringoplasty