Role of Hyaluronic Acid Gel as an Adjunct to Temporalis Fascia Graft Tympanoplasty in Total Tympanic Membrane Perforation: A Randomized Controlled Trial.

AIM: This study aimed to evaluate the efficacy of hyaluronic acid gel as an adjunct to temporalis fascia graft tympanoplasty in total tympanic membrane perforation. METHODS: A prospective single blinded randomized controlled trial carried out among 60 patients with total tympanic membrane perforation randomized into 2 groups A&B each comprised of 30 patients. Patients in group A underwent underlay tympanoplasty using temporalis fascia graft through postauricular approach with the utilization of hyaluronic acid gel as an adjunct to temporalis fascia graft. Patients in group B underwent classic underlay tympanoplasty using temporalis fascia graft through postauricular approach. Both groups were compared as regards graft success rate as well as hearing outcome. RESULTS: The difference in the graft success rate between group A (93.33%) and group B (80%) was statistically significant (P value = 0.04). Preoperative air conduction (AC) threshold and air bong gap (ABG) showed no statistically significant differences between both groups. Postoperative AC thresholds for groups A and B were 23.55 ± 3.69 dB and 26.40 ± 5.26 dB respectively with statistically significant difference (P value = 0.04). Postoperative ABG for groups A and B were 8.90 ± 4.07 dB and 12.00 ± 5.41 dB respectively and this difference was also statistically significant (P value = 0.03). CONCLUSION: Utilization of hyaluronic acid gel as an adjunct to temporalis fascia graft tympanoplasty can improve the graft success rate.