Failures in myringoplasty

Vartiainen, Eero; Kärjä, Juhani; Karjalainen, S.; Härmä, R

doi:10.1007/bf00464402

Cited by 42 publications

(21 citation statements)

References 11 publications

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“…Other preoperative factors like dry or wet ear, site of perforation or the grafting technique did not affect the graft take rate. 15 In our series, postoperative follow up showed complete control of otorrhea in 49 patients in dry group and 48 patients in wet group. 2 in wet and 1 dry ears showed persistent ear discharge.…”

supporting

confidence: 50%

A study of surgical outcomes of myringoplasty in active and inactive ears

Patel

Kulkarni

Jyothi

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Chronic otitis media (COM) can present with inactive (dry) and active (wet) ear. It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on active ears is decidedly inferior. Hence the present study is intended to find the outcome of ear surgeries in inactive and active ear with objective to find the incidence of graft uptake and hearing improvement in both the groups.Methods: A total of 50 active ear (with mucoid discharge) and 52 inactive ears (not discharging at least 3 month before surgery) with mucosal chronic otitis media underwent myringoplasty with cortical mastoidectomy. Graft take and hearing gain rates 3 and 6 months after surgery were calculated for both groups and compared. Results: The graft take rate was 90% for the active ear group and 94% for the inactive ear group. The hearing gain rate was 90% for the active ear group and 94% for the inactive ear group. Differences were found to be statistically insignificant for both graft intake (p=0.461) and hearing gain (p=0.543).Conclusions: The success of myringoplasty is not adversely affected by the presence of mucoid ear discharge at time of surgery, and outcomes are comparable to those of the opration done for inactive ears.

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supporting

confidence: 50%

A study of surgical outcomes of myringoplasty in active and inactive ears

Patel

Kulkarni

Jyothi

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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“…Some researchers are of the opinion that they are important variables in determining the post tympanoplasty hearing results [12][13][14]. On the other hand, some investigators have repeatedly emphasized that these variables do not in any way significantly influence the post-operative hearing results [4,[15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Hearing Results Post Tympanoplasty: Our Experience with Adults at the KKR ENT Hospital, India

Kolo

Ramalingam

2012

Indian J Otolaryngol Head Neck Surg

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Chronic suppurative otitis media is often associated with some degree of hearing loss. Tympanomastoid surgery is considered effective in controlling infection and preventing recurrence. However, opinions differ with regards the post-operative hearing results. This study aims to assess the hearing results, and also ascertain the effects of some variables on hearing in adult patients with chronic suppurative otitis media after primary tympanoplasty. This was a retrospective review of the clinical records of adult patients with chronic suppurative otitis media, who had primary tympanoplasty at the KKR ENT Hospital and Research Institute in Chennai (India), between 1st June and 30th September, 2011. A total of 26 adult patients with a mean age of 35.85 years (SD 14.775) were studied. There were 16 males (61.54 %) and 10 females (38.46 %). The commonest presenting symptoms were ear discharge (80.8 %) and hearing loss (76.9 %); and the mean duration of symptom was 8.52 years (SD 8.599). The overall mean pre-operative pure tone average was 49.58 dB (SD 18.608), while the overall mean post-operative pure tone average was 37.38 dB (SD 17.837). The difference between the overall mean pre-and post-operative pure tone average (hearing gain) was 12.192 dB (SD 12.924); and this was found to be statistically significant (p \ 0.05). Multiple linear regression model showed that only increasing age was significantly associated with increasing mean post-operative pure tone average. This study found primary tympanoplasty effective in improving hearing results in adults with chronic suppurative otitis media even in those with advanced ossicular lesions.

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“…This could probably be due to poorer vascular supply to a larger graft as a larger area of graft remains unsupported in space. 26 Aggarwal et al in their study observed higher success rates with smaller perforations (less than 50% of pars tensa). 27 Yoon et al in their study concluded that there were no significant relationships between surgical success rate and the status of the contralateral ear.…”

Section: Discussionmentioning

confidence: 82%

“…As a result, this might have affected the sound transmitting dynamics of the middle ear. 25 In a study conducted by Vartanien, 26 reperforations and graft failure were significantly more often in larger perforations sized >50% of drum area compared to smaller perforations (<50%). This could probably be due to poorer vascular supply to a larger graft as a larger area of graft remains unsupported in space.…”

Section: Discussionmentioning

confidence: 96%

Factors Influencing Surgical Outcome of Myringoplasty in Tubotympanic Type of Chronic Otitis Media

Das¹,

Das²

2017

jemds

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BACKGROUNDChronic otitis media is an inflammatory process of the mucoperiosteal lining of the middle ear space and mastoid. Infection of the middle ear has been a problem encountered in the human race, and is as old as humanity itself. Chronic suppurative otitis media (CSOM) is one of the most common causes of ear infection in developing countries particularly in South-east Asian countries. Chronic middle ear disease is a major problem in India especially in the rural areas. It is estimated that 6% of Indian population suffers from chronic ear disease. The term "Tubotympanic disease" is sometimes used to describe COM with a central perforation. The two principal aims of management of tubotympanic chronic otitis media are the eradication of infection and improvement of hearing by the closure of the tympanic membrane perforation which can be achieved either conservatively or by surgery. The surgical treatment of CSOM is still controversial. Some surgeons advice only repair of central perforation of tympanic membrane in non-cholesteatomatous tubotympanic chronic otitis media using graft i.e. myringoplasty to achieve a dry ear with improved hearing. This study aims to determine the factors responsible for successful surgical outcome of myringoplasty. MATERIALS AND METHODSThis hospital-based prospective study was done in the Dept. of ENT, Assam Medical College and Hospital, Dibrugarh from 1 st January 2015 to 31 st December 2015 in diagnosed cases of tubotympanic variant of CSOM. Thirty patients were included in this study after fulfilling inclusion and exclusion criteria. The surgical outcomes were assessed in terms of hearing gain, graft uptake and dryness of ear. RESULTSThirty patients of tubotympanic type of CSOM reviewed in the study with mean age group of 35.16 + 12.75 years underwent myringoplasty. Successful graft uptake post-operatively at 3 rd followup (12 th week) was seen in 83.33%. Dry ear was achieved at the end of 12 th week in 86.67% and gain in hearing at 3 rd post-operative review was 9.90 + 1.81 dB. 5 cases had graft failure, 4 cases failed to achieve dry ear. Extremity of ages, lower socio-economic status, postoperative URTI and ET dysfunction, disease in contralateral ear were associated factors in determining graft uptake and dry ear. CONCLUSIONMyringoplasty has been established as a very effective surgical management of tubotympanic variant of CSOM. Success of myringoplasty can be measured in terms of gain in hearing, graft uptake and dry ear. Our study acknowledges that successful outcome of surgery is determined by a range of factors like lower socio-economic status particularly in rural population with unhygienic living conditions, presence of nidus of infection in the upper airway along with eustachian tube dysfunction, otitis externa, disease in contralateral ear may be considered as some of the possible factors responsible for influencing the outcomes of surgery in tubotympanic type of chronic otitis media. But we emphasised that more cases or study population for longer duration...

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Failures in myringoplasty

Cited by 42 publications

References 11 publications

A study of surgical outcomes of myringoplasty in active and inactive ears

A study of surgical outcomes of myringoplasty in active and inactive ears

Hearing Results Post Tympanoplasty: Our Experience with Adults at the KKR ENT Hospital, India

Factors Influencing Surgical Outcome of Myringoplasty in Tubotympanic Type of Chronic Otitis Media

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