Success of lateral graft technique for closure of tympanic membrane perforations

We wished to determine if the success of lateral graft tympanoplasty was affected by either size of perforation, previous underlay tympanoplasty, or patient age.

A review was performed of patients who underwent lateral graft tympanoplasty by the senior author between March 2010 and July 2013 with patient number based on an a priori power analysis. Patient demographics, baseline clinical data, postoperative findings, and audiologic data were collected.

Lateral graft tympanoplasty.

The primary outcome was closure of perforation. The secondary outcome was change in air-bone gap.

Thirty patients were included with a mean follow-up period of 14 months. Closure of tympanic membrane perforation occurred in 93%. Closure was observed in 13 of 15 (87%) patients with perforations 50% or smaller and in all patients (15 of 15) with perforations larger than 50% (p = 0.48, Fisher's exact test). For revision cases, 8 of 9 (89%) were closed compared to 20 of 21 (95%) in primary tympanoplasty (p = 0.52). Perforations in adults and children were equally likely to be closed (10 of 11 children vs. 18 of 19 adults) (p = 1). The mean preoperative to postoperative air-bone gap improved from 24 ± 12 dB to 14 ± 8 dB (p = 0.0003, paired t test).

Lateral graft tympanoplasty has a high success rate for the closure of tympanic membrane perforations with a significant improvement in air-bone gap. There were no significant differences in success comparing small versus large perforations, primary versus revision tympanoplasty, or adults versus children.