Staining in Tympanoplasty; Is Methylene blue Rationale? by Bhushan Kathuria, Himani dhingra, Joginder gulia, Vikas kakkar, SPS Yadav, Sharad Hernot, and Surender bishnoi in GJO in Juniper Publishers
Objective:
Is there any advantages of using
methylene blue in myringoplasty? To compare the results of methylene blue
stained temporalis fascia graft with unstained temporalis fascia graft in
underlay myringoplasty.
Materials and Method:
In this prospective study, 120
patients of either sex in age group of 15-50 years with non-cholesteatomatous chronic
suppurative otitis media (CSOM) were recruited. Patients were initially managed
medically to make the ear dry and after that they were operated upon. Sixty patients underwent
underlay myringoplasty using methylene blue stained temporalis fascia graft and
60 patients underwent underlay myringoplasty using unstained temporalis fascia
graft. Follow-up period was at least 6 months.
Results:
Graft uptake and hearing improvement
was comparable in both groups. Although there was 10% higher graft uptake using
methylene blue stained temporalis fascia
(95%) as compared to unstained temporalis fascia graft (85%),however the
difference was not statistically significant (P = 0.5). But there was
statistically significant difference in gain in hearing threshold (gain in A-B
gap) in the myringoplasty using methylene blue stained temporalis fascia graft
(18 dB ±7.156) as compared to myringoplasty using unstained temporalis fascia
graft ( 13.7 dB ±5.70814) (P = 0.04).
Conclusion:
Methylene blue use in myringoplasty
allows improved identification of the graft, can be very helpful for trainee
residents and reduce the time of a graft placement. Also, methylene blue as an
antioxidant and antimicrobial properties, prevents degradation and lysis of
fascia graft, improves the overall success rate of graft uptake with no adverse
effects.
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