Comparison of Temporalis Fascia Graft Uptake in Patients with Large Tympanic Membrane Perforation Undergoing Type 1 Tympanoplasty

Background: Managing a large tympanic membrane perforation without middle ear disease involves reconstruction of tympanic membrane through tympanoplasty. Graft uptake may be highly influenced by the choice of either an endoscopic or microscopic modality. Objective: This study aimed at comparing graft uptake rates and hearing results for patients with large tympanic membrane perforations who received Type 1 tympanoplasty using temporalis fascia grafts via endoscopic and microscopic modalities. Methods: Sixty patients presenting with large-sized tympanic membrane perforations were divided into two different groups, Group A consisting of patients who underwent endoscopic tympanoplasty and Group B consisting of patients who underwent microscopic tympanoplasty. Intraoperative damage to chorda tympani nerve was monitored and post-operative pain was measuered by neumeric pain scale on 1st and 7th post-operative days. The graft uptake after 42 days of operation was analyzed and the hearing improvement was noted by using audiometric tests. The research took place at Sir Salimullah Medical College, Dhaka, Bangladesh, between July 2022 to June 2023. Results: Graft uptake in Group B was 90% while in Group A it was 83.33%. The average postoperative hearing gain in Group A and in Group B was 9.29 dB and 10 dB respectively. There has been no statistical significance found between the two techniques regarding graft uptake and hearing outcome but significant pain score was seen on 1st POD. Conclusion: Both the endoscopic and microscopic tympanoplasty techniques yielded similar graft uptake rates and hearing improvements in patients with large tympanic membrane perforations, thus the choice of technique should depend on surgeon preference rather than the expected outcome. More studies are needed in larger cohorts for the validation of these results.