All Cartilage No Stitch Type 1 Tympanoplasty – A Prospective Study

Introduction Although temporalis fascia is the commonly used graft material for tympanoplasty, cartilage has become the material of choice in cases with eustachian tube dysfunction, bilateral disease, total or anterior perforation of tympanic membrane, tympanosclerosis etc. Cartilage slices < 0.5 mm thick are similar to the tympanic membrane in their acoustic properties. The present study is aimed to describe stitch-less type 1 tympanoplasty with sliced tragal cartilage-perichondrium and evaluate anatomical, audiological and cosmetic outcomes. Materials and Methods A prospective study was conducted from March 2014 to August 2016, in ENT department of a Government Medical College and Hospital, West Bengal, India. Primary tympanoplasty cases irrespective of age, size and site of perforation, laterality and eustachian tube function were included in the study. History of previous tympanoplasty or mastoid surgery and cases requiring ossicular reconstruction or mastoidectomy were excluded from the study. Sliced tragal cartilage-perichondrium graft of 0.2 mm thickness was placed in underlay fashion through trans-canal or end-aural route. Results Among 95 cases 38 were male, 57 were female with age range between 7 to 68 years. Average operative time was 30 minutes. Graft take was successful in 97.89% of cases. Average Air Bone Gap 12 months after operation was 13.03dB. Conclusion Sliced cartilage-perichondrium graft gives good balance between sufficient stability and adequate acoustic sensitivity. Moreover, no stitch technique reduces operative time and increases cosmesis

Three Years’ Experience of Management of Different Types of Rhinosporidiosis in Rural Part of Western West Bengal

Introduction: The incidence of different types of rhinosporidiosis is very high in the rural western part of West Bengal.  The treatment of choice is surgical excision and cauterization of the base. The recurrence rate is very high. Aims and objectives: The objectives of this study were to assess the distribution of rhinosporidiosis according to age, sex, presenting features, site of origin, recurrence rate and compare them with literature; and describe the surgical technique to reduce recurrence of the disease. Materials and methods: This prospective case study was done in the department of Otorhinolaryngology in a tertiary care hospital in the western part of West Bengal from April 2012 to March 2015. Wide local excision of rhinosporidiosis along with electrocautery of the base was done. We took the help of endoscope and microscope whenever needed. Regular follow up with endoscope was done in postoperative period. Results: Out of total 112 patients 62 were male and 50 were female. Commonest age group affected was 2nd decade. There was no recurrence in patients undergoing operation for the first time. Recurrence was noted in nasopharynx of 3 patients undergoing revision surgery. Conclusion: Complete removal of rhinosporidiosis from the base is the basic criterion to reduce recurrence. It is possible by using meticulous technique along with the guidance of endoscope or microscope whenever needed. Regular postoperative follow up with endoscope is must to detect and treat early recurrence

All Cartilage No Stitch Type 1 Tympanoplasty – A Prospective Study

Introduction Although temporalis fascia is the commonly used graft material for tympanoplasty, cartilage has become the material of choice in cases with eustachian tube dysfunction, bilateral disease, total or anterior perforation of tympanic membrane, tympanosclerosis etc. Cartilage slices < 0.5 mm thick are similar to the tympanic membrane in their acoustic properties. The present study is aimed to describe stitch-less type 1 tympanoplasty with sliced tragal cartilage-perichondrium and evaluate anatomical, audiological and cosmetic outcomes. Materials and Methods A prospective study was conducted from March 2014 to August 2016, in ENT department of a Government Medical College and Hospital, West Bengal, India. Primary tympanoplasty cases irrespective of age, size and site of perforation, laterality and eustachian tube function were included in the study. History of previous tympanoplasty or mastoid surgery and cases requiring ossicular reconstruction or mastoidectomy were excluded from the study. Sliced tragal cartilage-perichondrium graft of 0.2 mm thickness was placed in underlay fashion through trans-canal or end-aural route. Results Among 95 cases 38 were male, 57 were female with age range between 7 to 68 years. Average operative time was 30 minutes. Graft take was successful in 97.89% of cases. Average Air Bone Gap 12 months after operation was 13.03dB. Conclusion Sliced cartilage-perichondrium graft gives good balance between sufficient stability and adequate acoustic sensitivity. Moreover, no stitch technique reduces operative time and increases cosmesis