Cartilaginous Myringoplasty: Anatomical and Functional Results

Myringoplasty remains a topical subject. Our study aims at analyzing the anatomical and functional results of cartilaginous myringoplasty, and also determining the main factors that could influence its results.

A retrospective study of 51 cases of tympanic perforations operated at the ENT department of the Hassan II University Hospital of Fez between January 2018 and November 2021. Only the patients with exclusive cartilage myringoplasty were included. The anatomical and functional results of cartilage myringoplasty were evaluated and analyzed according to several variables. The statistical analysis was performed using SPSS Statistics software.

The average age of our patients was 35, with a sex ratio of 2.45. The perforation was anterior in 58%, posterior in 12%, and central in 30% of the cases. The average pre-operative audiometric air bone gap (ABG) was 29.3 dB. The most commonly used graft was the conchal cartilage in 89% of cases. A complete cicatrization has been noticed in 92%, and at six months after surgery, a complete closure of the ABG has been observed in 43% of cases, a significant hearing improvement with an ABG between 11 and 20 dB in 24%, a hearing recovery with an ABG between 21 and 30 dB in 21%, and an ABG > 30 dB in 12% of the cases. A statically significant relationship (p<0.05) has been found between the functional or anatomical failure of the myringoplasty; the different predictive factors were: the young age (less than 16 years), the inflammatory state of the tympanic cavity, the anterior location, and large size of the perforation.

Cartilaginous myringoplasty provides good anatomical and auditory results. The pre-operative predictive factors, such as age, complete and sufficient drying of the ear, the size and location of the perforation, and the size of the used cartilage, should all be considered for a better anatomical and functional outcome.