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A safe and comparable alternative to BIPP packing following tympanoplasty for tympanic membrane perforation

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

Abstract

Purpose

To compare two post-operative ear packing methods following tympanoplasty for tympanic membrane perforation.

Methods

A prospective study of patients undergoing tympanoplasty for tympanic membrane perforation over a 2-year period was undertaken across two district general hospitals. Data, including demographics, pre-operative ear state, and graft type used for repair were recorded. Ears were packed using one of two distinct methods. Pack A: gelatin sponge, chloramphenicol ointment and an antibiotic-soaked ear wick. Pack B: antibiotic-soaked gelatin sponge, bismuth iodoform paraffin paste (BIPP) impregnated gauze dressing. The primary outcome measure was post-operative complications associated with each packing method

Results

One hundred and fifty-three tympanoplasties were performed during this period: 68 underwent Pack A and 85 underwent Pack B. Chi squared test showed no significant association between pack type and complication rate (p = 0.572). Univariate analysis suggested that age (p = 0.047) and concurrent bony canaloplasty (p = 0.006) significantly increased complication rates. Pre-operative ear status, indication, graft type and gender did not affect complication rate.

Conclusions

BIPP-impregnated ribbon gauze and chloramphenicol/wick are both comparable methods for packing an ear following tympanoplasty for tympanic membrane perforation. This is useful information both for surgeons who commonly use BIPP and have a patient with a known iodine allergy, or who is not known to be allergic to iodine but has been packed with BIPP previously, and for those who do not have access to BIPP and wish to use a pack with comparable success.

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Funding

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Author information

Authors and Affiliations

  1. Department of Otolaryngology, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Southend-on-Sea, SS0 0RY, UK

    Sheneen Meghji, Wahidah Wahid & Aaron Trinidade

  2. Luton and Dunstable Hospital NHS Trust, Luton, UK

    Eyal Schechter

  3. East Kent University Hospitals NHS Foundation Trust, Canterbury, UK

    Codruta Neumann

Authors
  1. Sheneen Meghji
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  2. Wahidah Wahid
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  3. Eyal Schechter
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  4. Codruta Neumann
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  5. Aaron Trinidade
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Contributions

SM was responsible for data collection and preparation of the manuscript. WW was responsible for data collection and data analysis. ES was responsible for manuscript editing and proofreading. CN was one of the surgeons whose outcomes were the subject of this study and was responsible for the overall integrity of the final manuscript. AT was one of the surgeons whose outcomes were the subject of this study, supervised the study and was responsible for the overall integrity of the final manuscript.

Corresponding author

Correspondence to Aaron Trinidade.

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Conflict of interest

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Ethics approval

Waiver granted by Southend University Hospital Ethics Committee.

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Not applicable; this was a retrospective service provision study.

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Not applicable.

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Available on request.

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Meghji, S., Wahid, W., Schechter, E. et al. A safe and comparable alternative to BIPP packing following tympanoplasty for tympanic membrane perforation. Eur Arch Otorhinolaryngol 278, 3683–3687 (2021). https://doi.org/10.1007/s00405-020-06426-5

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  • DOI: https://doi.org/10.1007/s00405-020-06426-5

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