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Myringoplasty: impact of perforation size on closure and audiological improvement
J D Wasson1, C E Papadimitriou, H Pau
1Department of Otolaryngology, Luton and Dunstable Hospital, UK. josephwasson@hotmail.com
Objectives:
To investigate the impact of perforation size and other variables on the success of myringoplasty, and also to determine audiological gain following successful closure of tympanic membrane perforations of various sizes.
Study Design:
Retrospective analysis of 130 case notes.
Main Outcome Measures:
(1) Successful closure of tympanic membrane following myringoplasty, in relation to recorded variables (i.e. perforation size, grade of surgeon, surgical technique, graft material, previous myringoplasty and smoking history). (2) Mean, four-frequency, air conduction audiometric gain following successful myringoplasty for various, pre-operatively categorised tympanic membrane perforation sizes.
Results And Conclusion:
The collective myringoplasty success rate was 80.8 per cent (105/130); for successful patients, the mean air conduction audiometric gain was -6.8 dB (t = 5.29, p < 0.0001). Neither perforation size nor any other assessed variable was a statistically significant determinant factor for successful myringoplasty. Air conduction audiometric gains following successful myringoplasty were directly correlated with pre-operative perforation size (-4.0 dB for 0-20 per cent perforations, -5.0 dB for 21-40 per cent, -9.1 dB for 41-60 per cent, -10.8 dB for 61-80 per cent and -13.3 dB for 81-100 per cent).
Insights
Myringoplasty success rates were 80.8%, with audiological gain averaging -6.8 dB. Perforation size did not impact success, but larger perforations correlated with greater hearing gain after myringoplasty.
Area of Science:
- Otolaryngology
- Surgical Outcomes
- Audiology
Background:
- Myringoplasty is a surgical procedure to repair tympanic membrane perforations.
- Factors influencing myringoplasty success and audiological outcomes require further investigation.
Purpose of the Study:
- To evaluate the impact of perforation size and other variables on myringoplasty success.
- To determine audiological gain after successful tympanic membrane closure.
Main Methods:
- Retrospective analysis of 130 patient case notes.
- Assessed myringoplasty success based on perforation size, surgeon grade, technique, graft material, prior surgeries, and smoking history.
- Measured four-frequency air conduction audiometric gain post-surgery.
Main Results:
- Overall myringoplasty success rate was 80.8%.
- No statistically significant correlation was found between perforation size or other assessed variables and surgical success.
- Mean air conduction audiometric gain was -6.8 dB for successful procedures.
- Greater pre-operative perforation size correlated with increased air conduction audiometric gain post-myringoplasty.
Conclusions:
- Myringoplasty demonstrates a high success rate.
- Perforation size and other evaluated factors do not significantly predict surgical success.
- Audiological gains are influenced by the initial size of the tympanic membrane perforation.
