Permeatal ‘push through’ myringoplasty in the Northern Territory: a prospective cohort

Abstract

Background: The permeatal cartilage 'push through' tympanoplasty is a safe and effective technique that has previously been shown to be beneficial in a variety of settings. This study examines its efficacy in a population with high proportions of Indigenous Australians who live in remote areas and have a high burden of chronic suppurative middle ear pathology. Methods: Multi-centre prospective case series. Two hundred and forty-one patients underwent transcanal "push-through" myringoplasty in the Northern Territory of Australia between January 01, 2012 and January 01, 2014. Graft integrity, air-bone gap closure and pure-tone average (PTA) thresholds were recorded at 1-5 months post operatively and after 12 months. Results: At 1-5 months, 87.2% of patients had successful grafts and intact tympanic membranes. Beyond 12 months, 84.4% of patients continued to have intact grafts and tympanic membranes. Less than 20% of patients had a residual hearing loss of more than 30 dB after the surgery. The air-bone gap was significantly lower after surgery (P<0.001). Conclusions: 'Push Through' myringoplasty has a favourable success rate when compared to conventional methods employed in the Aboriginal population (30-64%) and provides the patient with a safe ear and improved hearing.

Comparison of endoscopic butterfly-inlay versus endoscopic push-through myringoplasty in repairing anterior perforations of the tympanic membrane

“…Reported graft uptake rate ranges between 84.4 and 97.4 per cent in patients who underwent endoscopic push-through myringoplasty. 4,8,13,14 Kim et al . reported a perforation closure rate of 91.3 per cent in patients undergoing modified butterfly-inlay cartilage (comprising one side perichondrium as in our study) myringoplasty.…”

“…In studies reporting butterfly-inlay and push-through cartilage myringoplasty outcomes, a significant improvement in ABG values was observed without a remarkable difference in both techniques. 1,4,7,8,14–16 According to a recent study comparing the functional results of fascia and cartilage graft, Mouna et al . reported that there was no significant difference between fascia and cartilage grafts in terms of auditory functions.…”