Myringoplasty Outcomes From a 5-Year Single Surgeon’s Experience and Important Surgical Technical Aspects

Abstract

Background and Objectives: The United Kingdom (UK) national standard for the closure rate for myringoplasty is 89.5% (90.6% and 84.2% for primary and revision surgeries, respectively). The average hearing gains for primary and revision myringoplasty are 9.14 dB and 7.86 dB, respectively. This study compared the myringoplasty outcomes for a single surgeon over 5 years.Subjects and Methods: Data for 68 cases were analyzed retrospectively. The outcome measures were achievement of the tympanic membrane closure and the average hearing gain or loss.Results: The overall and primary closure rates were 97% and 98%, respectively and significantly higher than the UK national standard (p=0.0210 and p=0.0287, respectively). The revision closure rate was 93%; however, it was not significantly higher than the national standard (p=0.1872). The average hearing gain was 5.18 dB. The gains for primary and revision surgeries were 5.15 dB and 5.25 dB, respectively.Conclusions: We propose that these outcomes are a result of our surgical technique, including the simultaneous use of cortical mastoidectomy in ears with discharge.

Recurrent tympanic perforation after myringoplasty: a narrative literature review and personal experience

“…In order to maximise the results, some surgeons opt to perform simultaneous canal-wall up cortical mastoidectomy in chronically discharging ears, especially in case of hyperplastic and polypoid chronic otitis media and in ET dysfunctions 64 . The opening of abnormal mastoid cells and the resection of granulations will both remove a future source of infection that may result in graft failure and improve middle ear aeration 65 , 66 .…”

“…The opening of abnormal mastoid cells and the resection of granulations will both remove a future source of infection that may result in graft failure and improve middle ear aeration 65 , 66 . However, conflicting evidence exists regarding the benefit of this additional procedure 64 , 67 .…”

Effect of Packing Versus No Packing in Transperforation Myringoplasty for Chronic Tympanic Membrane Perforations

“…Myringoplasty is the principal procedure used to repair chronic perforations of the tympanic membrane (TM). Two key traditional steps of underlay myringoplasty are rimming of the perforation and packing of the external auditory canal (EAC) to hold the graft in situ and prevent graft lateralization and cholesteatoma development, thereby improving the graft success rate 1‐6 . Packing of the EAC increases the required number of follow‐up visits and patient discomfort.…”