[Prognostic factors influencing anatomic and functional outcome in myringoplasty]

The objectives of myringoplasty are essentially two: restore the eardrum integrity and improve hearing level. We have carried out a retrospective study of myringoplasties performed in our Department, between 1996 to 2000, corresponding to 197 surgical interventions, in 162 patients. The characteristics more frequently seen for operating ears were central localization of tympanic membrane perforation, dry ear, good eustaquian tube function and underlay technique placing fascia graft. Endaural or retroauricular approach were similar in number. We obtained 73.6% of anatomic success, though in some cases we needed to reoperate the patient. When we analysed risk factors of anatomic success, we noticed than only the tympanic perforation site had influence, with better rate in posterior perforations and lower rate in subtotal perforations. We analysed functional results in ears with anatomic success, finding 75.6% of hearing level improvement with a gap of less than 20 dB. Factors influencing hearing improvement were surgeon experience and the presence of middle ear alterations.