الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Since the 1600s otologists have attempted to restore hearing loss due to infections of the middle ear and tympanic membrane perforation. Marcus Banzer was the first to propose a prosthesis as a tympanic membrane substitute in 1640. In 1952 tympanoplasty was popularized by Wullstein using split-thickness skin grafts. The grafting materials evolved. Heermann was the first to use the temporalis fascia graft in 1960. Goodhill used perichondrium for grafting the tympanic membrane in the 1960s. Twenty-three known different methods of cartilage tympanoplasty have evolved over the past few decades; most are underlay or onlay techniques. One of the most recent methods is an inlay grooved cartilage myringoplasty which was published in 1998 by Eavey. In this method cartilage is inserted inlay like a grommet tube, in our current study; we did not use any skin grafts as published initially by Eavey instead of that we used platelet-rich fibrin (PRF) instead of that. A total of 50 patients with CSOM with dry perforation were involved in this study and divided into two groups; group A (25 patients) & group B (25 patients), 22 were females, and 28 were males. Their ages ranged from 13 to 65 years. Perforation size ranged from small to medium ≤ 50% of the size of the whole tympanic membrane. Cases of group A were done in this thesis using the Endoscopic Inlay Grooved Myringoplasty with the application of autologous PRF and cases of group B were also operated by the same technique but without the use of autologous PRF. The overall graft take rate was 96% (24/25) for group A, while the graft take rate in group B was 76% cases (19/25). As regards the hearing gain: For group A; The postoperative hearing gain was 5-10 dB was found in 11 patients (44%), 11-15 dB in eight patients (32%), 16-20 dB in four patients (16%), ≥ 21 in one patient (4%) & one patient represents (4%) did not improve at all. For group B; The postoperative hearing gain was 5-10 dB was found in seven patients (28%), 11-15 dB in six patients (24%), 16-20 dB in five patients (20%), ≥ 21 in one patient (4%) & seven patients represent (28%) did not improve at all. The inlay grooved cartilage myringoplasty is a good alternative to some older methods of tympanoplasties in well-selected cases. Our procedure is well tolerated by patients with no or minimal pain in most of the cases. It is so far much better than pain suffered with cases of post-auricular incision which may last to a week or two and postoperative tingling and numbness which is often felt by patients due to cutting of some sensory skin branches in the post-auricular incision. The success rate of this technique could be best guarantee based on the application of PRF. Topical PRF application is safe and highly efficient and successful with no reported complication. Not only it enhances healing of the graft, but also protects it from infection. During follow-up of our patients, no graft retraction occurred. Cartilage can resist deformation from pressure variations and is less susceptible to graft loss, despite being placed in a hostile environment. Despite graft stiffness, hearing does not appear to be detrimentally impacted.