A Study of the Effect of Tensor Tympani Release in Myringoplasty on Post Operative Middle Ear Compliance

Madhumitha, H (2012) A Study of the Effect of Tensor Tympani Release in Myringoplasty on Post Operative Middle Ear Compliance. Masters thesis, Coimbatore Medical College, Coimbatore.


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OBJECTIVES: To evaluate the changes in post operative middle ear compliance after myringoplasty with release of the tensor tympani tendon in patients with dry large central perforations. DESIGN: Experimental ; randomized control study. DURATION AND SETTING: This study was conducted in the Department of ENT, Coimbatore Medical College Hospital from February 2010 to October 2011. METHODOLOGY: A total of 50 patients with unilateral tubotympanic type of CSOM, having large central perforations, dry for at least 3 months with medialised handle of malleus were selected after ruling out Eustachian tube dysfunction. Out of them, 25 each were designated into control and study groups. Myringoplasty was done in the routine manner in the control group ; the tensor tympani was released during myringoplasty in the study group. Patients were reviewed periodically and at the end of the third month, were compared in terms of graft take, subjective hearing improvement, post-operative air bone gap, graft mobility, medialisation and post operative tympanometry. RESULTS: Graft success rates were approximately similar in boyh groups(92% & 88%).The mean post operative air bone gap (16.45dB and 14.45Db in control and study groups)showed no significant difference, but patients belonging to study group reported better subjective hearing improvement. The proportion of A, AS, and B curves on postoperative tympanometry was 9%,22% and 68 % in the control group , while in the study group it was 15%,68% and 20 % respectively showing a significant change in post operative compliance among both, The proportions of patients with graft medialisation and immobile graft were higher in the control group. (medialisation rates : 45 % in controls, 15% in study patients.Graft mobility : 32 %controls and 75% study group). CONCLUSION: Tensor tympani tendon release in patients with medialised malleus handle has a definitive role in establishing post operative middle ear compliance in the range of normalcy , ensuring efficient middle ear function. Further studies are needed to evaluate its long term effects before it can be routinely adopted.

Item Type: Thesis (Masters)
Additional Information: Reg.No.22092241
Uncontrolled Keywords: Tensor tympani, medialisation of malleus, post operative impedance, graft mobility.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 14 Sep 2020 17:02
Last Modified: 14 Sep 2020 17:02
URI: http://repository-tnmgrmu.ac.in/id/eprint/13137

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