Nasal septal perichondrium versus temporalis fascia in transmeatal myringoplasty

الملخص EN

Objective: The aim of this study was to compare between nasal sepal perichondrium and temporalis fascia in surgical repair of tympanic membrane perforation.

Patients and methods: A prospective study was done on 40 patients from the out-patient clinics of otorhinolaryngology department of El-Minia University Hospital with ages ranging between 18 and 54.

All patients had a persistent, symptomatic tympanic membrane perforation, and 20 patients out of 40 had nasal obstruction due to nasal septal deviation.

All patients were scheduled for myringoplasty by a transmeatal approach in combination with septoplasty – for the patients with deviated nasal septum – under general anesthesia.

In 20 patients, nasal septal perichondrium was taken and used as a graft for transmeatal myringoplasty.

In the remainder 20 patients, myringoplasty was done by using temporalis fascia as a graft.

Results: Sixteen out of 20 patients (80%) nasal septal perichondrium grafts were successfully uptaken.

In temporalis fascia group, 17 out of 20 (85%) perforations had been successfully closed.

As regards hearing, all patients of both groups had more than 5 dB HL improvement in conductive hearing thresholds of at least three frequencies.

An overall success rate of 92% was recorded in terms of hearing improvement.

No significant differences were present between both groups as regards healing and hearing improvement.

Conclusion: In patients with simultaneous myringoplasty and septoplasty nasal septal perichondrium was better to be used as a graft material for repair of tympanic membrane perforation to avoid the post-auricular incision to obtain temporalis fascia.

In addition, nasal septal perichondrium has other advantages, it is easily accessible, cost-effective, time saving and is sufficiently large.