Abstract
Objectives
The aim of this study was to determine influencing factors on tympanic membrane closure and their consequence on absolute risks of closure and hearing improvement in myringoplasties.
Design
Retrospective cohort.
Setting
Medium-sized medical centrum.
Participants
195 patients were analysed who underwent a myringoplasty between January 2015 and February 2017 at the Jeroen Bosch Hospital in The Netherlands.
Main outcome measures
Patient-related data, descriptions of the tympanic defect, surgical data, and the most important follow-up data were collected. Primary outcome is successful closure of the tympanic membrane and the secondary outcome is the amount of air–bone gap improvement after surgery.
Results
The overall success rate of the myringoplasty graft was 74.9%. If cartilage and butterfly graft were used, higher success rates of 85.4% and 85.5% were achieved compared to temporalis fascia (61.3%). Success rate of the operation was dependent of the skills of the surgeon. Chances of success are 91.9% if the operation is performed by an experienced surgeon using cartilage and 66.7% if a less experienced surgeon uses fascia. If a postoperative complication occurs or when silastic sheets are used, this might have a negative effect on the success of the operation. The mean ABG improved 10.10 dB if the perforation was closed compared to 3.38 dB after an unsuccessful procedure.
Conclusion
The success rate of a myringoplasty is dependent of the skills of the surgeon and type of graft used and varies between 91.9 and 52.0% depending on these factors.
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References
Onal K, Uguz MZ, Kazikdas KC, Gursoy ST, Gokce H (2005) A multivariate analysis of otological, surgical and patient-related factors in determining success in myringoplasty. Clin Otolaryngol 30(2):115–120
Tringali S, Dubreuil C, Bordure P (2008) Tympanic membrane perforation and tympanoplasty. Ann Otolaryngol Chir Cervicofac 125(5):261–272
Jalali MM, Motasaddi M, Kouhi A, Dabiri S, Soleimani R (2017) Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 127(9):2139–2148
Khan MM, Parab SR (2015) Comparative study of sliced tragal cartilage and temporalis fascia in type I tympanoplasty. J Laryngol Otol 129(1):16–22
Lee P, Kelly G, Mills RP (2002) Myringoplasty: does the size of the perforation matter? Clin Otolaryngol Allied Sci 27(5):331–334
Wasson JD, Papadimitriou CE, Pau H (2009) Myringoplasty: impact of perforation size on closure and audiological improvement. J Laryngol Otol 123(9):973–977
Dangol K, Shrivastav RP (2017) Study of various prognostic factors affecting successful myringoplasty in a Tertiary Care Centre. Int Arch Otorhinolaryngol 21(3):250–254
Sharma DK, Singh S, Sohal BS, Singh B (2009) Prospective study of myringoplasty using different approaches. Indian J Otolaryngol Head Neck Surg 61(4):297–300
Nepal A, Bhandary S, Mishra SC, Singh I, Kumar P (2007) Assessment of quantitative hearing loss in relation to the morphology of central tympanic membrane perforations. Nepal Med Coll J 9(4):239–244
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van Stekelenburg, B.C.A., Aarts, M.C.J. Determinants influencing success rates of myringoplasty in daily practice: a retrospective analysis. Eur Arch Otorhinolaryngol 276, 3081–3087 (2019). https://doi.org/10.1007/s00405-019-05611-5
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DOI: https://doi.org/10.1007/s00405-019-05611-5