Abstract
ROLE OF COMPOSITE GRAFT IN TYPE 1 TYMPANOPLASTY

Type 1 tympanoplasty is done to reconstruct the tympanic membrane. There is evolution of tympanic membrane grafting with various graft materials. Temporalis fascia is most commonly used but there is rise in use of tragal cartilage-perichondrium (composite graft) as it offers resistance from middle ear pressure changes and provides excellent acoustic results. The aim of our study was to compare the functional outcome of temporalis fascia and tragal cartilage-perichondrium (composite graft) as graft materials for the Type I tympanoplasty. A total of 80 cases in the age group of 11-60 years with chronic suppurative otitis media were studied. They were divided into group A and group B with 40 cases in each group. Temporalis fascia graft was used in Group A while tragal cartilage-perichondrium (composite graft) was used in Group B. The results were evaluated in the form of graft take-up and acoustic gain. The male to female ratio was found to be 1.17:1. Majority (41.25%) patients were of age group 11-20 years. Graft uptake rate at the end of 1-year follow-up in Group A and B were 90% and 97.5% respectively. Post-operative air-bone gap closure <10 dB in Group A and B were 85% and 77.5% respectively. Our study showed that functional outcome with respect to graft uptake was comparatively better in the tragal cartilage-perichondrium (composite graft) group. The temporalis fascia group showed better AB gap closure. Composite graft is a suitable alternative to temporalis fascia as it provides protection from retraction pocket formation and re-perforation with minimal interference in the sound transmission.