International Journal of Otorhinolaryngology and Head and Neck Surgery | February 2021 | Vol 7 | Issue 2 Page 308
International Journal of Otorhinolaryngology and Head and Neck Surgery
Ankle NR et al. Int J Otorhinolaryngol Head Neck Surg. 2021 Feb;7(2):308-312
http://www.ijorl.com
pISSN 2454-5929 | eISSN 2454-5937
Original Research Article
Evaluation of graft uptake using temporalis fascia and cartilage
perichondrium supplemented with autologous platelet rich plasma in
tympanoplasty
N. R. Ankle, Rajesh Radhakrishna Havaldar, Sweta Sinha*
INTRODUCTION
Temporalis fascia remains the most frequently used graft
material with closure of the tympanic membrane in 70%
to 90% of primary tympanoplasties in different hands.
However, in some situations such as advanced middle ear
pathology, retraction pockets, and atelectatic ears,
temporalis fascia tends to undergo atrophy in the
subsequent postoperative period regardless of placement
techniques.
1
Our dissatisfaction with the temporalis fascia
with a higher incidence of recurrent perforations
compelled us to use a tougher material that would not
only prevent reperforation but also prevent retractions.
Cartilage has shown to be a promising graft material to
close perforations in the tympanic membrane. Although it
is similar to temporalis fascia, its more rigid quality tends
to resist resorption, retraction, and reperforation, even in
the milieu of continuous eustachian tube dysfunction.
2
ABSTRACT
Background: Tympanoplasty involves grafting the perforation of the tympanic membrane with materials such as
temporalis fascia, cartilage perichondrium, periosteum, vein, fat etc. Both temporalis fascia and cartilage
perichondrium are easy to harvest with minimum donor site complications and both have been used extensively in
tympanoplasty. Platelet rich plasma aids as an adhesive and supplements healing by providing growth factors. Till
date there is scarcity of literature comparing the healing outcome of both cartilage perichondrium and temporalis
fascia supplemented with platelet rich plasma. Hence, in this study we are comparing cartilage perichondrium
supplemented with platelet rich plasma and temporalis fascia supplemented with platelet rich plasma.
Methods: An observational study involving 60 patients was done. Patients with chronic otitis media were evaluated
by otoendoscopy to assess the ear and were categorised into 2 groups which received temporalis fascia and cartilage
perichondrium respectively. All cases were supplemented with platelet rich plasma. Post-operative assessment was
done by otoendoscopy.
Results: Total 21 patients received temporalis fascia and 39 patients received cartilage perichondrium. At the end of 6
weeks the graft site appeared unhealthy in 6.66% cases who received temporalis fascia and 1.66% in those who
received cartilage perichondrium.
Conclusions: We found that cartilage perichondrium supplemented with platelet rich plasma had a better uptake after
6 weeks due to its superior mechanical stability. The results are more rewarding than the use of temporalis fascia with
platelet rich plasma.
Keywords: Temporalis fascia, Tympanoplasty, Cartilage perichondrium, Platelet rich plasma
Department of ENT and Head and Neck Surgery, J. N. Medical College, Belagavi, Karnataka, India
Received: 03 November 2020
Revised: 24 December 2020
Accepted: 26 December 2020
*Correspondence:
Dr. Sweta Sinha,
E-mail: swetaankita@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/issn.2454-5929.ijohns20210162