Clinical Analysis of Paper Patch Myringoplasty in Patients with Tympanic Membrane Perforations

Lee, Dong Hee; Kim, Jisun; Shin, Eunhye; Kim, Yulgyun; Cho, Yesun

doi:10.5152/iao.2016.2565

Cited by 5 publications

(6 citation statements)

References 6 publications

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“…The success rate of procedure in our study is 91.2% which is similar to or better than that reported by various authors. 11,[14][15][16][17][18][19] However, our general success rate is lower than that reported by Lou et al 17 In their study, almost 98% of 504 cases with traumatic TM perforations were acute onset (within 1 month after a trauma), and a spontaneous healing rate of 89% cases was reported. In our study, all perforations with traumatic etiology healed well, whereas the ones in which the procedure failed had inflammatory etiology.…”

Section: Discussioncontrasting

confidence: 57%

Office myringoplasty by chemical cauterization and paper patching: a prospective study

Upreti

2018

Int J Otorhinolaryngol Head Neck Surg

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Background: Surgery for tympanic membrane perforation entails its own morbidity, risk of anesthesia, psychological trauma, along with long waiting periods for patients, especially in a tertiary care centre like ours. The purpose of this study was to evaluate outcomes of chemical cauterization and patching of perforation, performed as an office procedure in select cases.Methods: The study was conducted in a tertiary hospital from January 2016 to December 2017. The patients were selected based on the inclusion criteria, after thorough clinical assessment, examination under microscope and pure tone audiogram. All cases underwent cauterization of margins of perforation using 10% trichloroacetic acid (TCA), followed by patching with appropriately sized pre-sterilized cigarette paper patch. The patients were followed up weekly till the perforation was completely healed or till 12 weeks. If required, the procedure was repeated. Results: 68 cases were included in the study. Most common site of perforation was antero-inferior quadrant of pars tensa. Most common etiology was inflammatory. Number of applications ranged from 1 to 3. The procedure was successful in 62 cases (91.2%). All cases with traumatic perforation, residual perforation post-surgery and persistent perforation after grommet extrusion healed well. All 6 cases with treatment failure had inflammatory etiology, 4 involving postero-superior quadrant.Conclusions: In patients with small, central, dry perforation of tympanic membrane, chemical cauterization using TCA and paper patching can yield results comparable to that of surgery, while abating the morbidity and psychological trauma of surgery and saving time for both patient and doctor.

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Section: Discussioncontrasting

confidence: 57%

Office myringoplasty by chemical cauterization and paper patching: a prospective study

Upreti

2018

Int J Otorhinolaryngol Head Neck Surg

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“…Twenty‐two studies reported outcomes of paper patches for repair of TM perforations 13–34 . Several different types of paper were utilized, including rice paper, cigarette paper, and paper patch (not otherwise specified).…”

Section: Resultsmentioning

confidence: 99%

“…The remaining studies were either EBM level 3 (33%) or level 4 (34%). The mean score of the 41 nonrandomized studies assessed using the MINORS system was 13 ± 4 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Forty percent of all RCTs were investigations of paper patch grafting.…”

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

“…A single study by Lindeman et al 31 performed myringoplasty using paper patch in pediatric patients under general anesthesia. Ten publications 13,[15][16][17][18][19][24][25][26][27] mentioned additional edge trimming in the procedure methodology. When sorted by perforation etiology, we found lower closure rates for perforations caused exclusively by otitis media (three articles, 20,26,29 range, 10.0%-52.2%) versus trauma (11 articles, [14][15][16][21][22][23]25,[31][32][33][34] range, 80.0%-95.2%).…”

Section: Patching Materials: Paper Patchmentioning

confidence: 99%

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A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

et al. 2020

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Objectives Nonautologous graft materials may solve several dilemmas in tympanoplasty by obviating the need for graft harvest, facilitating consistent wound healing, and permitting graft placement in the clinical setting. Prior studies of nonautologous grafts in humans have shown variable outcomes. In this systematic review, we aim to 1) summarize clinical outcomes and 2) discuss limitations in the literature regarding nonautologous grafts for tympanoplasty in humans. Methods A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) recommendations. The study size, etiology and duration of perforation, type of nonautologous graft, and postoperative closure rate were assessed. Results The PRISMA approach yielded 61 articles, including 3,247 ears that met inclusion criteria. Studies evaluated nonautologous grafts including paper patch, gelatin sponge, growth factors, porcine small‐intestinal submucosa, among others. Traumatic perforations (62.3%) were most commonly studied, whereas postinfectious perforations (31.9%) and other etiologies (5.8%) comprised a minority of cases. Acute perforations of <8 weeks duration constituted just over half of all treated ears. Overall closure rate was 82.1%, with significantly higher closure rates in acute (89.9%) versus chronic perforations (64.9%, P < .01), regardless of material. A median postoperative air‐bone gap of 5.6 dB was found in the 23% of studies reporting this metric. Conclusions The majority of publications reviewing nonautologous materials in tympanoplasty evaluate acute or traumatic perforations, and few rigorously report hearing outcomes. Given available data, porcine submucosa and basic fibroblast growth factor may hold promise for chronic perforation closure. Future studies should report closure rates and hearing outcomes in perforations >8 weeks duration. Laryngoscope, 131:392–400, 2021

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“…Two articles investigated the predictive factors of fat graft myringoplasty (FGM) [37,41] and one article investigated paper patch myringoplasty [42]. These methods differ from traditional techniques, because the tympanomeatal flap is not elevated during the procedure.…”

Section: Fat Graft and Paper Patch Myringoplastymentioning

confidence: 99%

Factors influencing successful reconstruction of tympanic membrane perforations: a systematic review and meta-analysis

Illés

Gergő

Keresztély

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Based on a systematic review and meta-analysis, our study aimed to provide information about the factors that influence the success of tympanic membrane reconstruction. Methods Our systematic search was conducted on November 24, 2021, using the CENTRAL, Embase, and MEDLINE databases. Observational studies with a minimum of 12 months of follow-up on type I tympanoplasty or myringoplasty were included, while non-English articles, patients with cholesteatoma or specific inflammatory diseases, and ossiculoplasty cases were excluded. The protocol was registered on PROSPERO (registration number: CRD42021289240) and PRISMA reporting guideline was used. Risk of bias was evaluated with the QUIPS tool. A random effect model was used in the analyses. Primary outcome was the rate of closed tympanic cavities. Results After duplicate removal, 9454 articles were found, of which 39 cohort studies were included. Results of four analyses showed significant effects: age (OR: 0.62, CI 0.50; 0.78, p value: 0.0002), size of the perforation (OR: 0.52, CI 0.29; 0.94, p value: 0.033), opposite ear condition (OR: 0.32, CI 0.12; 0.85, p value: 0.028), and the surgeon’s experience (OR: 0.42, CI 0.26; 0.67, p value: 0.005), while prior adenoid surgery, smoking, the site of the perforation, and discharge of the ear did not. Four factors: etiology, Eustachian tube function, concomitant allergic rhinitis, and duration of the ear discharge were analyzed qualitatively. Conclusions The age of the patient, the size of the perforation, the opposite ear status, and the surgeon’s experience have a significant effect on the success of tympanic membrane reconstruction. Further comprehensive studies are needed to analyze the interactions between the factors. Level of evidence Not applicable.

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Clinical Analysis of Paper Patch Myringoplasty in Patients with Tympanic Membrane Perforations

Cited by 5 publications

References 6 publications

Office myringoplasty by chemical cauterization and paper patching: a prospective study

Office myringoplasty by chemical cauterization and paper patching: a prospective study

A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

Factors influencing successful reconstruction of tympanic membrane perforations: a systematic review and meta-analysis

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