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Comparison of perichondrium–cartilage double and single underlay myringoplasty for subtotal perforations: a randomized controlled trial

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

Abstract

Objective

The objective of this study was to compare graft outcome, operation time and surgical complications of the double and single perichondrium–cartilage underlay techniques for repairing subtotal tympanic membrane (TM) perforations.

Materials and methods

Patients with unilateral subtotal perforations undergoing myringoplasty were prospectively randomized to undergo DPCN or SPCN. The operation time, graft success rate, audiometric outcomes, and complications were compared between these groups.

Results

In total, 53 patients with unilateral subtotal perforations were included (DPCN group, 27; SPCN group, 26).All patients completed 6 months of follow-up. The mean operation time was 41.2 ± 1.8 min in the DPCN group and 37.2 ± 5.4 min in the SPCN group, the difference was not significant (p = 0.613).The graft success rates were 96.3% (26/27) in the DPCN group and 73.1% (19/26) in the SPCN group, the difference was significant (p = 0.048). During the period of follow-up, residual perforation was found at postoperative in one (3.7%) in the DPCN group, while cartilage graft slipped (graft lateralization) in 2 (7.7%) and residual perforation in 5 (19.2%) were found in the SPCN group, the difference of residual perforation was not significant among two group (p = 0.177).In addition, no significant between-group differences were observed pre- (p = 0.741) or post- (p = 0.687) operative ABG values or mean ABG gain (p = 0.659) (Table 2).The functional success rates (postoperative ABG ≤ 20 dB) were 85.2% (23/27) in the DPCN group and 73.1% (19/26) in the SPCN group (p = 0.454).

Conclusion

Although similar functional result and operation time can be obtained with double perichondrium–cartilage underlay technique compared to the single perichondrium–cartilage underlay technique for endoscopic closure of subtotal perforations, double unerlay technique offers better anatomical result with minimum complications.

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Data availability

All data generated or analyzed during this study are included in the published article.

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Funding

This study was supported by Health Commission of Zhejiang province, China (Grants#2021KY1186), Shanghai Medical innovation project, China (Grants#22Y11902100), Technology Agency of Jinhua city, China (Grants#2022–3-042).

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Author notes

  1. Zhengcai Lou and Zihan Lou have contributed equally to this work.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Yiwu Central Hospital, 699 Jiangdong Road, Yiwu City, 322000, Zhejiang Province, China

    Zhengcai Lou & Tian Lv

  2. Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China

    Zihan Lou, Dongzhen Yu, Jingjing Wang & Zhengnong Chen

  3. Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yishan Road 600, Shanghai, 200233, China

    Zihan Lou, Dongzhen Yu, Jingjing Wang & Zhengnong Chen

  4. Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China

    Zihan Lou, Dongzhen Yu, Jingjing Wang & Zhengnong Chen

  5. Shanghai Key Lab Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China

    Zihan Lou, Dongzhen Yu, Jingjing Wang & Zhengnong Chen

Authors
  1. Zhengcai Lou
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Contributions

ZL: interpretation of data for the work, design of the work, analysis of data for the work, drafting the work, agreement to be accountable for all aspects of the work; final approval of the version to be published; ZL: interpretation of data for the work, analysis of data for the work, drafting the work and technical the diagram, agreement to be accountable for all aspects of the work, and final approval of the version to be published; DY and JW: analysis of data for the work, and final approval of the version to be published; TL: analysis of data for the work; agreement to be accountable for all aspects of the work; ZC: interpretation of data for the work, design of the work, final approval of the version to be published.

Corresponding authors

Correspondence to Zhengcai Lou or Zhengnong Chen.

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Conflict of interest

None (all the authors confirm that).

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the local Ethics Committee of Yiwu central hospital review board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (protocol number:K2020-IBR-027).

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Informed consent was obtained from all of the participants.

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Lou, Z., Lou, Z., Yu, D. et al. Comparison of perichondrium–cartilage double and single underlay myringoplasty for subtotal perforations: a randomized controlled trial. Eur Arch Otorhinolaryngol 280, 4861–4868 (2023). https://doi.org/10.1007/s00405-023-08004-x

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