EXPERIENCE IN TYMPANOPLASTY WITH ALLOGRAFT TYMPANIC MEMBRANE

A study of tympanoplasties using allograft tympanic membrane with or without ossicles for 33 patients with conductive deafness during the period of 1980. 10 through 1984. 8 is presented with respect to primary take rate, type of allograft used and postoperative hearing changes. Out of 33 cases, 5 fell into necrosis and 6 perforation, allograft take rate being 84% (completely 67%). But those 5 cases of necrosis are included among initial 17 cases and no more necrosis occurred among another 16 cases, in which combination use of temporal fascia or pedicled epi-thelial flap were used. For 29 cases tympanoplasty using allograft ear drum attached with or without ossicles have been done and for another 4 cases only transplantation of ear drum attached with malleus have been done as first step of staged operation. Type of allograft trans-plantations grouped into 3 according to the number of ossicles attached to the tympanic membrane;Group A: Tympanic membrane only. Group B: Tympanic membrane attached with malleus. Group C: Tympanic membrane attached with malleus and incus. In group A (4 cases), small ossicles or PORP were placed between allograft drum and recipients stapes.In group B of 17 cases, various management for ossicular continuity were made. i. e. con-nection between allograft malleus and (i) stapes footplate of a recipients with tragal cartilage (2 cases). (ii) head of the stapes with notched incus (9 cases). In one case allograft drum necrotized and two cases provided successful results in rest of 6. (iii) recipient's retracted malleus in 3 cases, two of which resulted in necrosis. (iv) recipient's deformed incus or stapes (2 cases). Both cases were congenital aural atresi and provided good hearing gain of 27dB and 42dB respectively.In group C (8 cases), 2 cases necrotized and one perforated. Final results provided 6 successful hearing results.