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Title: Endoscopic Fascia-Cartilage Composite Grafting in Chronic Suppurative Otitis Media
Authors: Zeeshan Ayub, Amir Ali Khan, Atif Rafique, Irfan Saeed, Junaid Alam
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2022
Volume: 72
Issue: 4
Language: English
DOI: 10.51253/pafmj.v72i4.7733
Keywords: Air-bone gapCartilageChronic suppurative otitis media
Objective: To evaluate perforation of an air-bone gap closure success using fascia-cartilage composite graft in endoscopic Trans canal tympanoplasty.
Study Design: Randomized Control Trial (Clinical Trials.gov Identifier: NCT04945811)
Place and Duration of Study: ENT Department Combined Military Hospital, Quetta Pakistan, from Apr 2020 to May 2021
Methodology: One hundred and thirty-three cases of chronic Suppurative otitis media fulfilling the selection criteria were operated upon, and an endoscopic fascia-cartilage composite graft was used. A successful outcome in terms of perforation closure and air-bone gap closure was evaluated in all patients.
Results: In the 138 patients operated, complete fascia-cartilage composite graft uptake was achieved in 129 (93.5%) patients. Nine (6.5%) patients had graft failure. The pre-operative mean air-bone gap was 36.49 ± 4.61 decibels, and the postoperative mean air-bone gap was 12.57 ± 5.09 decibels. This improvement was found to be significant, with the p-value < 0.001.
Conclusion: Endoscopic per-meatal fascia-cartilage composite grafting has a high graft uptake and air-bone gap closure percentage in chronic Suppurative otitis media cases.
To evaluate the success of perforation and air-bone gap closure using fascia-cartilage composite graft in endoscopic trans-canal tympanoplasty for chronic suppurative otitis media.
Randomized Control Trial (Clinical Trials.gov Identifier: NCT04945811) conducted at the ENT Department, Combined Military Hospital, Quetta, Pakistan, from April 2020 to May 2021. One hundred and thirty-eight adult patients with chronic suppurative otitis media and dry central perforation were operated on using an endoscopic fascia-cartilage composite graft. Pre- and post-operative air-bone gaps were evaluated using pure tone audiometry.
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A["Patient Selection CSOM, dry central perforation"] --> B["Pre-operative Audiometry & CT Scan"];
B --> C["Endoscopic Fascia-Cartilage Composite Grafting"];
C --> D["Post-operative Audiometry"];
D --> E["Data Analysis"Paired t-test""];
E --> F["Conclusion on Graft Uptake & Air-Bone Gap Closure"];
The study highlights the effectiveness of endoscopic fascia-cartilage composite grafting in chronic suppurative otitis media, demonstrating high graft uptake and significant improvement in air-bone gap closure. This technique offers advantages over traditional methods by minimizing risks of canal scarring and stenosis while providing a robust graft with easier manipulation.
Complete fascia-cartilage composite graft uptake was achieved in 129 (93.5%) patients. The mean pre-operative air-bone gap was 36.49±4.61 decibels, which significantly improved to a mean post-operative air-bone gap of 12.57±5.09 decibels (p-value < 0.001).
Endoscopic per-meatal fascia-cartilage composite grafting is a successful technique for chronic suppurative otitis media, leading to high graft uptake and significant improvement in auditory thresholds and air-bone gap closure.
1. Study Design: Randomized Control Trial (NCT04945811). Confirmed in the text.
2. Sample Size: 138 patients were operated upon. Confirmed in the text.
3. Graft Uptake: 93.5% graft uptake was achieved. Confirmed in the text.
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