 He had already had a previous tympanoplasty, but even outside the areas where the graft was taken, the temporalis muscle was quite atrophied and lumpy, and I suspect this was due to his chronic disease and long history of corticosteroid usage. 
He had already had a previous tympanoplasty , but even outside the areas where the graft was taken , the temporalis muscle was quite atrophied and lumpy , and I suspect this was due to his chronic disease and long history of corticosteroid usage .