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The Effect of External Auditory Canal Packing Duration on Healing After Endoscopic Cartilage Myringoplasty
1Department of Otorhinolaryngology, Yiwu Central Hospital, Yiwu, Zhejiang, China.
Introduction:
The external auditory canal (EAC) packing is widely used in otosurgery and is considered to promote hemostasis and to support tympanic membrane grafts. However, few studies have investigated the effects of packing removal time on healing.
Objective:
We investigated the effect of EAC packing duration on healing after endoscopic cartilage myringoplasty in patients with chronic tympanic membrane perforations (TMPs).
Materials And Methods:
Patients with chronic TMPs who underwent endoscopic "push-through" cartilage myringoplasty were divided into early and late groups based on the length of time before EAC packing was removed. The graft success rate, eardrum appearance, and hearing gain were assessed 3 months after surgery.
Results:
The study included 137 patients. Three months after surgery, the graft success rate was 83.5% (66/79) in the early group and 94.8% (55/58) in the late group (P = .042). The graft was displaced in 8 (10.1%) patients in the early group and in 1 (1.7%) patient in the late group (P = .050). No epithelialization was found on the surface of the grafts in the early group, whereas epithelialization was nearly complete 4 weeks after surgery in the late group.
Conclusions:
Delaying removal of the EAC packing after endoscopic cartilage myringoplasty may promote tympanic membrane better healing and cartilage graft epithelialization and improve the appearance of the eardrum.
Insights
Delaying external auditory canal (EAC) packing removal after endoscopic cartilage myringoplasty improves tympanic membrane healing and graft epithelialization. This approach enhances graft success rates and eardrum appearance in patients with chronic perforations.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Regenerative Medicine
Background:
- External auditory canal (EAC) packing is standard in otosurgery for hemostasis and graft support.
- Limited research exists on the impact of EAC packing removal timing on healing outcomes.
Purpose of the Study:
- To evaluate the effect of EAC packing duration on healing after endoscopic cartilage myringoplasty for chronic tympanic membrane perforations (TMPs).
Main Methods:
- 137 patients with chronic TMPs underwent endoscopic
- push-through
- cartilage myringoplasty.
- Patients were stratified into early and late EAC packing removal groups.
- Graft success, eardrum appearance, and hearing gain were assessed at 3 months post-surgery.
Main Results:
- The late removal group showed a significantly higher graft success rate (94.8%) compared to the early group (83.5%).
- Graft displacement was less frequent in the late removal group (1.7% vs. 10.1%).
- Complete epithelialization of cartilage grafts was observed in the late group by 4 weeks, unlike the early group.
Conclusions:
- Delayed EAC packing removal post-endoscopic cartilage myringoplasty promotes superior tympanic membrane healing.
- Extended packing duration enhances cartilage graft epithelialization and improves eardrum appearance.
- This strategy may lead to better functional and aesthetic outcomes in tympanoplasty procedures.
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