[Primary myringoplasties. Results after a 2 year follow-up period]

The goals of myringoplasty are closure of the perforation in the tympanic membrane and improvement in hearing levels, with varying results in the published literature. Our aim was to determine the results of this procedure at our centre and compare them with the literature.

Retrospective analysis of 217 primary myringoplasties carried out in the Otorhinolaryngology Department of the Ramón y Cajal University Hospital between 1998 and 2003, describing the characteristics of the perforations, surgical technique and post-operative results (perforation closure and hearing improvement).

The majority were adults with perforations secondary to recurrent middle ear infections (91%). Most were less than subtotal (64%) and did not involve the tympanic annulus (79%). Grafts were inserted using lateral (45%), mixed (29%) and medial (26%) techniques, using retroauricular (66%) and endaural (34%) approaches. Temporal muscle fascia was the graft most frequently used (87%). Perforation closure was achieved in between 78% and 91% of cases throughout the 24-month follow-up period, with an overall closure value of 78% after 2 years of follow-up. Hearing improvement, established as an air bone gap difference of less than 20 dB, was seen in approximately 56% of cases.

At our centre, myringoplasty achieves anatomical (78%) and functional (56%) success comparable to the results described in the literature. We consider medium-term follow-up to be of the utmost importance because of reperforation phenomena, which may occur as much as 2 years or more after surgery.