Temporalis Fascia Grafting in Large/Subtotal Perforation; A Review of 60 Cases

Objective: To demonstrate the surgical techniques and to compare the anatomical and functional outcomes of type I underlay tympanoplasty using temporalis fascia graft in patients with large/subtotal perforation. Material method: Temporalis fascia grafting has been done in 60 patients having large/ subtotal perforations. Pure tone audiogram (PTA) and speech reception thresholds (SRT) were carried out preoperatively and each postoperative visit i.e. at the end of 1, 3 6 and 24 months.10 dB closure of air bone gap and 10 dB improvement in SRT were considered significant. Results: The graft uptake rates were 92% the end of 24 months. 90% of patients had significant improvement in hearing (ABG ≥10 dB).The mean improvement of the SRT was 10 dB and 75% of the patients had significant gains in SRT. Conclusion: Repair of large or subtotal perforation has been always a challenge to the otologist and temporalis fascia graft is an ideal autograft for the above purpose. Circumferential elevation of tympanomeatal flap can be effectively performed to have a better anatomical and functional outcome in patients undergoing type I tympanoplasty for large and subtotal perforation.