Perichondrium Vs Temporalis Fascia Graft Pak Armed Forces Med J 2021; 71 (Suppl-3): S622 COMPARISON BETWEEN TRAGAL CARTILAGE WITH PERICHONDRIUM AND TEMPORALIS FASCIA GRAFT BY UNDERLAY ENDOSCOPIC TYMPANOPLASTY Muhammad Tahir, Asim Abbass, Faiz Ul Hassan Nawaz, Syed Asad Shabir*, Atif Rafique** Karachi Institute of Medical Sciences, Karachi Pakistan, *Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, **Combined Military Hospital Multan/ National University of Medical Sciences (NUMS) Pakistan ABSTRACT Objective: To compare the results of tragal cartilage with perichondrium versus temporalis fascia graft in endoscopic tympanoplasty using underlay technique. Study Design: Comparative prospective study. Place and Duration of Study: Study conducted in Tertiary Care Hospital, Karachi, from Jul 2018 to Feb 2020. Methodology: Overall, 34 patients having permanent unilateral tympanic membrane perforations were included in this study, in whom underlay endoscopic tympanoplasty was performed. Group A patients underwent temporalis fascia graft while group B received a tragal cartilage with perichondrium graft. The success rate between groups was compared in respect of reduction in postoperative air-bone gap and healing of perforation. Results: The success rate of graft was 88% (30/34) in group A and 94% (32/34) in group B after 6 months follow-up, the difference was not found to be statistically significant (p=0.368). Hearing improvement in the form of closure of air bone gap in group A was from 24.52 ± 1.73 dB (decibel) to 13.56 ± 5.67s dB and in group B it was from 19.76 ± 3.47dB to 11.94 ± 3.9dB, the difference was not significant statistically (p=0.333). Conclusion: Keeping in view the results of our study, we conclude that both tragal cartilage with perichondrium and temporalis fascia graft are considered equally successful in endoscopic tympanoplasty. Keywords: Endoscopic tympanoplasty, Tragal Cartilage with perichondrium graft, Temporalis fascia graft, Underlay technique tympanoplasty. How to Cite This Article: Tahir M, Abbass A, Nawaz FUH, Shabir SA, Rafique A. Comparison Between Tragal Cartilage with Perichondrium and Temporalis Fascia Graft by Underlay Endoscopic Tympanoplasty. Pak Armed Forces Med J 2021; 71 (Suppl-3): S622-625. Doi: https://doi.org/10.51253/pafmj.v1i1.5819 INTRODUCTION Tympanic membrane (TM) perforations are serious health hazard. These, mostly result from acute otitis media which is second most commonly encoun- tered infection in Pediatrics. Secondly, these are seen in chronic otitis media which may or may not be associa- ted with cholesteatoma. About 3-5% cases of grommet insertion also result in permanent TM perforations. Other main cause is barotrauma to ears. 1 Chronic tympanic membrane perforations adver- sely affect patient’s hearing mostly conductive but can also affect sensorineural in some cases. It increases their probability of developing acute as well as chronic otitis media and tympanosclerosis. Patient can have potential complications like balance disorders, mening- itis, thrombosis in sigmoid sinus and brain abscesses. Current managements of chronic tympanic membrane perforations are either observation with precautions of water entry into ear or repair by surgery. 2 Tympanoplasty is an operation carried out for repairing the eardrum perforation and the hearing mechanism can also be reconstructed. 3 Successful re- pair of these perforations is satisfying for both the ope- rating surgeon as well as the patient. Hearing can im- prove up to 25dB. In most of cases, ear discharge as well as tinnitus is also improved. 4 Conventional tymp- anoplasty, done with postauricular incision under mic- roscope is very effective technique for patients having permanent TM perforation. This is especially useful in cases of anterior or large eardrum perforations or those having anterior bony overhang. This technique causes a surgical scar and substantial ache to the patient. In order to reduce operation time and pain levels, endo- scopic tympanoplasty has gained more popularity as compared to microscopic tympanoplasty. 5 Endoscopic tympanoplasty offers excellent middle ear structures visibility and has been found very useful for repairing large tympanic membrane perforations with fewer complications and less invasiveness. 6 Since start of tympanoplasty, several different graft materials have been tried for closure of TM perforation e.g. conchal cartilage, temporalis fascia and veins. Other less popular choices include skin, dura mater, fascia lata, xenograft and pericardium. 7 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Correspondence: Dr Muhammad Tahir, Department of ENT, Combined Military Hospital Malir-Pakistan mzahid689@gmail.com Original Article Open Access