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Graft take-rates after tympanoplasty: results from a prospective ear surgery database
Steven Arild Wuyts Andersen1, Kristine Aabenhus, Henrik Glad
1*Department of Otorhinolaryngology-Head and Neck Surgery, Rigshospitalet, Copenhagen; and †Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, Køge, Denmark.
Objective:
To present a prospective ear surgery database and investigate the graft take-rate and prognostic factors for graft take-rate in tympanoplasty using the database.
Study Design:
Prospective database study.
Setting:
Tertiary referral center.
Patients:
A total of 1606 cases undergoing tympanoplasty types I to IV were registered in the database in the period from February 2004 to November 2013.
Intervention:
A total of 837 cases underwent myringoplasty/tympanoplasty type I.
Main Outcome Measure:
Graft take-rate and prognostic factors (age, discharge at time of surgery, tuba function, technique, graft material, and revision surgery) for tympanoplasty type I were studied. A comparison with the graft take-rates for tympanoplasty types II to IV and/or cholesteatoma was made.
Results:
A user-friendly ear surgery database with fast data entry and direct import of audiometric data was developed. The graft take-rate was found to be 93.0% at 2 to 6 months and 86.6% at more than 12 months. Except for a discharging ear at the time of surgery, no significant differences using χ² test of association were found when comparing graft take-rates for different prognostic factors or more advanced tympanoplasty with or without cholesteatoma. A long-term graft take-rate overestimation of 6% was found if cases with defaulted follow-up because of early reperforation were not included.
Conclusion:
A prospective database can be used to study prognostic factors and reduce bias in reporting the graft take-rate. Prospective databases are needed for high-quality longitudinal studies but require a continuous and daily effort of involved surgeons and therefore need to be convenient and fast to use.
