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The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
[Myringoplasties. A retrospective analysis of our surgical outcomes]
Ramón Balaguer García1, María M Morales Suárez-Varela, José M Tamarit Conejeros
1Servicio de Otorrinolaringología, Hospital Universitario Dr. Peset, Valencia, España. balaguergarcia@gmail.com
Objective:
The aim of this study was to present, myringoplasty case results in our department. Different factors were studied to confirm their prognostic value.
Materials And Methods:
A total of 126 myringoplasties from 2006 until 2010 were reviewed, collecting patient-related details, descriptions of the anatomical defect and the most interesting surgical aspects.
Results:
Subtotal perforations (35.7%) were the most frequently observed. In 89.7% of the operations, the transcanal approach was preferred. The medial technique (underlay) to the tympanic membrane was the most performed (97.6%). Cartilage was the principal graft used (82.5%). Complete closure of the perforation was obtained in 71.1% of the cases at 6 months follow-up. Recurrences of the perforations were of minimal size in 11.9% of the cases, partial in 11.1% and with a cartilage fragment gap in 4.8%. The mean time in which these defects were registered was 3.82 months. The mean post-operative auditory gain was 12.8 decibels at 6 months.
Conclusions:
Myringoplasty is an appropriate technique for restoring tympanic integrity and obtaining functional benefit. Dried middle ear mucosa and posterior perforations seem to be related with better functional results.
Insights
Myringoplasty effectively restores tympanic membrane integrity and improves hearing. Factors like dry middle ear mucosa and posterior perforations correlate with better surgical outcomes in myringoplasty procedures.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Auditory Health
Background:
- Tympanic membrane perforations are common middle ear issues.
- Myringoplasty is a surgical technique to repair these perforations.
- Understanding factors influencing myringoplasty success is crucial for patient outcomes.
Purpose of the Study:
- To present myringoplasty case results from a specific department.
- To evaluate various factors for their prognostic value in myringoplasty.
Main Methods:
- Retrospective review of 126 myringoplasty cases (2006-2010).
- Data collected included patient details, perforation anatomy, and surgical techniques.
- Analysis focused on factors potentially impacting surgical success and hearing gain.
Main Results:
- Subtotal perforations were most common (35.7%).
- Transcanal approach (89.7%) and underlay technique (97.6%) were preferred.
- Cartilage grafts were used in 82.5% of cases, achieving 71.1% complete closure at 6 months; mean auditory gain was 12.8 dB.
Conclusions:
- Myringoplasty is an effective procedure for tympanic membrane repair and functional recovery.
- Favorable outcomes appear associated with dry middle ear mucosa and posterior perforation locations.
- The study highlights the efficacy of myringoplasty in restoring auditory function.
