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Factors affecting the treatment outcomes of myringoplasty in patients with small tympanic membrane perforations

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Factors affecting the outcomes of myringoplasty have been widely discussed but remain controversial. In this study, we retrospectively analyzed the factors associated with the outcomes of myringoplasty treating small tympanic membrane perforations (defined as those involving less than 30% of the whole eardrum area) in patients with a history of chronic otitis media.

Methods

The clinical demographic data, preoperative pure tone audiometry, surgical procedures, and surgical outcomes of patients with small tympanic perforations were analyzed statistically. Overlay myringoplasty was performed in 24 ears (45.27%); Gelfoam® plugs were placed in 29 ears (54.73%). Univariate and multivariate tests among demographic, surgical procedure-related, hearing test-related factors were performed.

Results

A total of 53 patients (22 males and 31 females) were enrolled (mean age 54.84 ± 15.51 years). Fourteen patients (26.41%) had the habit of cigarette smoking, 8 (15.09%) had diabetes mellitus, 20 (37.73%) had a past history of chronic otitis media, 5 (9.43%) had a history of grommet insertion, 5 (9.43%) had received radiotherapy in the head and neck region, and 1 (1.88%) had microtia. The success rate for overlay myringoplasty using Silastic® sheets was 54.16%; the success rate for Gelfoam® plugs was 54.16%. On univariate analysis, smoking, older age, and the mean air conduction and bone conduction hearing levels significantly affected the surgical outcomes. Cigarette smoking was the only independent (negative) prognostic factor of surgical success on multivariate analysis (OR  = 0.1614, 95% CI: 0.0336–0.7762, p = 0.0228).

Conclusion

As for surgical repair for the small tympanic membrane perforations with a history of chronic otitis media, age, cigarette smoking, mean air conduction threshold, and mean bone conduction threshold were associated with surgical outcomes; cigarette smoking was the independent predictive prognostic factor for the surgical outcomes.

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Abbreviations

COM :

Chronic otitis media

PTA :

Pure tone audiometry

DM :

Diabetes mellitus

AC :

Air conduction

BC :

Bone conduction

ABG :

Air–bone gap

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Acknowledgments

The authors thank all the members of Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, for their invaluable help.

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Authors and Affiliations

  1. Department of Otolaryngology and Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan

    Shih-Lung Chen

  2. School of Medicine, Chang Gung University, Taoyuan, Taiwan

    Shih-Lung Chen & Shih-Wei Yang

  3. Department of Otolaryngology and Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan

    Shih-Wei Yang

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Contributions

Resources: S-LC, S-WY. Supervision: S-WY. Writing—original draft: S-LC. Writing—review and editing: S-LC, S-WY.

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Correspondence to Shih-Wei Yang.

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Chen, SL., Yang, SW. Factors affecting the treatment outcomes of myringoplasty in patients with small tympanic membrane perforations. Eur Arch Otorhinolaryngol 276, 3005–3012 (2019). https://doi.org/10.1007/s00405-019-05583-6

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  • DOI: https://doi.org/10.1007/s00405-019-05583-6

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