Tri-adcortyl ointment ear dressing in myringoplasty: an analysis of outcome

Abstract

In a retrospective study of patients who had undergone myringoplasty at our department within a 12-month period, we assessed the graft take rate using tri-adcortyl ointment (TAO) as ear dressing. Data including age, site and size of perforation, grade of surgeon, surgical approach, use of postoperative ear dressings, complications and audiometric outcome was collected from the patient notes and analysed. The overall success rate of the operation (with success being defined as an intact tympanic membrane at 6 months) was noted. Seventy-seven patients were operated, but data were complete on 64 patients and these constituted the study population. TAO was used in 95% of the patients and BIPP gauze pack in the remaining 5%. Age ranged from 8 to 63 years (mean 34 years). Mean follow-up period was 13 months. Most of the operations (72.88%) were carried out by consultants with a success rate of 89% and the remaining patients were operated by trainees with a success rate of 88% (P = 1.000). The overall success rate was 89, 90.16% for TAO and 66.66% (2 out of 3) for BIPP (P = 0.298), 95% for small and 86% for subtotal perforations (P = 0.573), 85% for anterior and 100% for posterior perforations (P = 0.240), 91% for adult patients and 88% for children (P = 1.000). TAO is a suitable ear dressing in myringoplasty. Routine use of TAO did not affect the success rate of myringoplasty at our centre.

A comparative study of external ear canal packing in endoscopic ear surgery; Outcomes of Spongostan and Silastic-based ear packing on a cohort of 153 cases

“…Fisal Et.al [9]had similar outcomes with BIPP packing and no packing and just overlaying absorbable Spongostan over the tympanomeatal ap in a cohort of middle ear surgeries. With regards to myringoplasty, Triadcortyl packing was found to have similar outcomes to BIPP [12] and a literature review by Ashraf and Capper[8] found no signi cant difference between different dressing types in myringoplasty success via the microscopic route. On the contrary, in endoscopic ear surgery, dressing characteristics like those of BIPP that include antiseptic properties along with splinting properties of the gauze volume may be less relevant due to the lesser tissue dissection.…”

“…The different approach that is used in comparison to the microscopic ear surgery results in lesser tissue dissection and thus potentially less pain [5] and a lesser need to control the wound healing process with speci c ear packing [6] The healing process may affect the outcomes and dressings anecdotally have been postulated to have an impact on healing and post-operative results. Several studies have been conducted concerning dressings for traditional microscopic ear surgery [7]- [12]. One of the popular packing options for traditional ear surgery in the UK has been Bismuth Iodoform Para n Paste impregnated gauze but several other alternatives are widely used like tri-adcortyl ointment-based dressings, Silastic splints, merocele, pope wick, etc [7], [8].…”