Normally epithelial migration is from the centre to the periphery . We denuded the handle of malleus during tympanoplasty . How does the epithelial growth occur over the underlay graft we place??
Dear Sir, The healing Graft usually does tempo for sound and if there is a chance of more tempo(vibration) there are chances for the epithelial growth that side and the sixq and shape and depth of the ear canal counts a lot for the healing tympanum and its converged sound wave (The sound pinch effect) so I believe that one of the cause is responsible for the growth of the epithelium over the underlying graft. Thanks
Thank you sir. But could you mention the pattern in which the growth takes place over the graft?
Hello Dr. Kartik. Role of temporalis fascia in tympanoplasty is it just acts as a scafold over which epithelium of tympanic membrane migrates so it helps in early healing of perforation. As we know that blood supply to the tympanic membrane is from periphery to centre and along the handle of malleus so healing takes place in the same way by formation of granulation and as well as fibrocytes migrates so all 3 layers gets developed.
But we say that epithelial migration normally is from the centre to the periphery in a normal intact TM right madam? The grommet we insert also migrates in that pattern eventually towards the periphery.
In tympanoplasty we freshen the margins and place the graft under the annulus but over the handle of malleus many a times. So in this the epithelial migration pattern would change correct? Ie.from the periphery to the centre?
Hello Dr. Kartik.
What you wanted to say is partly correct. Rate of epithelial migration is maximum in posterosuperior quadrants next is posteroinferior and then anteroinferior last is anterosuperior quadrant. So we get problems in posterosuperior quadrants commonly. But during healing for epithelium to migrate process should stath
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