Factors affecting hearing improvement following successful repair of the tympanic membrane

Thiel, Gundula; Mills, R; Mills, Nicholas L.

doi:10.1017/s0022215113000157

Cited by 7 publications

(19 citation statements)

References 18 publications

(14 reference statements)

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“…Based on the literature, between 52% and 91.5% of patients have been reported to have improved hearing following surgery. 1,6,7,9 Improvement of >10 dB AC PTA 4 in 40% of patients in the present study may seem low but could be explained by already normal hearing preoperatively in 50% of the patients. In the group of patients with impaired hearing preoperatively, 61% improved.…”

Section: Comparison With Other Studiescontrasting

confidence: 61%

“…It is most often performed to prevent infections and/or to improve hearing. 1,2 There is evidence that myringoplasty is a procedure with few complications and good patient satisfaction. [3][4][5] Myringoplasty shows a graft take rate of approximately 64%-95%, 3,4,[6][7][8] and there is a good chance of hearing improvement; studies show improvement rates from 52% to 91.5%.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] Myringoplasty shows a graft take rate of approximately 64%-95%, 3,4,[6][7][8] and there is a good chance of hearing improvement; studies show improvement rates from 52% to 91.5%. 1,6,7,9 However, there is a risk that hearing could deteriorate even if the TM is healed. 10,11 In Sweden, approximately 900 myringoplasties are performed each…”

Section: Introductionmentioning

confidence: 99%

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Hearing outcome after myringoplasty in Sweden: A nationwide registry‐based cohort study

Berglund

Olaison

Bonnard

et al. 2020

Clinical Otolaryngology

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Objectives: To present hearing results after successful primary myringoplasty surgeries registered in the Swedish Quality Registry for Myringoplasty and to evaluate the chance of hearing improvement and the risk of hearing loss. Design: A retrospective nationwide cohort study based on prospectively collected registry data between 2002 and 2012. Settings: Registry data from secondary and tertiary hospitals performing myringoplasty. Participants: Patients with healed tympanic membrane after primary myringoplasty surgery performed from 2002 to 2012 in Sweden. Main outcome measures: Postoperative hearing results, hearing gain and air-bone gap (ABG). Results:In 2226 myringoplasties, air conduction audiograms were recorded, and the average preoperative pure tone average (PTA 4 ) of the group was 28.5 dB, which improved postoperatively to 19.6 dB with an average of 8.8 dB improvement. Bone conduction was measured for 1476 procedures. Closure of the ABG to 10 dB or less was achieved in 51% of the ears and to less than 20 dB in 89% of the ears. Sixty-one percent of patients with preoperatively deteriorated hearing experienced improved hearing, but 3% of all patients experienced deteriorated hearing. After the surgery, 93% of the patients were satisfied. Conclusions:Hearing results after successful myringoplasty surgery are often favourable, but although the tympanic membrane is healed, hearing improvement is not guaranteed, and hearing deterioration can also occur.

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Section: Comparison With Other Studiescontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hearing outcome after myringoplasty in Sweden: A nationwide registry‐based cohort study

Berglund

Olaison

Bonnard

et al. 2020

Clinical Otolaryngology

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“…In addition, greater hearing gains can be expected in successful operations on large perforations. 28 Perforations were classified into three groups (small, medium, and large), but in other studies they are classified as large or small. The success rate for small and medium-sized perforations was similar, suggesting that subdividing the group of perforations occupying <50% of the drum into subgroups is not clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

Results of myringoplasty operations in active and inactive ears in adults

2013

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“…(1–3) Currently the gold standard is type 1 tympanoplasty (myringoplasty) with over one hundred thousand cases being performed in the United States every year. (4) However, initial graft take rates can be as low as sixty five percent.…”

Section: Introductionmentioning

confidence: 99%

Heparin Binding Epidermal Growth Factor-Like Growth Factor Heals Chronic Tympanic Membrane Perforations With Advantage Over Fibroblast Growth Factor 2 and Epidermal Growth Factor in an Animal Model

Maria

Weierich²,

Kim³

et al. 2015

Otology &Amp; Neurotology

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Hypothesis That heparin binding epidermal growth factor like growth factor (HB-EGF) heals chronic tympanic membrane (TM) perforations at higher rates than fibroblast growth factor 2 (FGF2) and epidermal growth factor (EGF) in an animal model. Background A non-surgical treatment for chronic TM perforation would benefit those unable to access surgery or those unable to have surgery, as well as reducing the cost of tympanoplasty. Growth factor (GF) treatments have been reported in the literature with variable success with the lack of a suitable animal providing a major obstacle. Methods The GFs were tested in a validated mouse model of chronic TM perforation. A bio absorbable hydrogel polymer was used to deliver the GF at a steady concentration as it dissolved over four weeks. A control (polymer only, n=18) was compared to polymer loaded with HB-EGF (5ug/ml, n=18), FGF2 (100ug/ml, n=19) and EGF (250ug/ml, n=19). Perforations were inspected at four weeks. Results The healing rates, as defined as one hundred percent perforation closure, were control (5/18, 27.8%), HB-EGF (15/18, 83.3%), FGF2 (6/19, 31.6%) and EGF (3/19, 15.8%). There were no differences between FGF2 (p=0.80) and EGF (p=0.31) with control healing rates. HB-EGF (p= 0.000001) showed a significant difference for healing. The HB-EGF healed TMs showed layers similar to a normal TM, whilst the other groups showed a lack of epithelial migration. Conclusion This study confirms the advantage of HB-EGF over two other commonly used growth factors and is a promising non-surgical treatment of chronic TM perforations.

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Factors affecting hearing improvement following successful repair of the tympanic membrane

Abstract: Greater hearing improvement can be expected following successful repair of perforations involving more than 50 per cent of the drum area. Poorer results are likely to occur in ears with additional middle-ear pathology and in revision cases.

Cited by 7 publications

References 18 publications

Hearing outcome after myringoplasty in Sweden: A nationwide registry‐based cohort study

Hearing outcome after myringoplasty in Sweden: A nationwide registry‐based cohort study

Results of myringoplasty operations in active and inactive ears in adults

Heparin Binding Epidermal Growth Factor-Like Growth Factor Heals Chronic Tympanic Membrane Perforations With Advantage Over Fibroblast Growth Factor 2 and Epidermal Growth Factor in an Animal Model

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