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Updated: Jul 29, 2025

Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Effect of Packing Versus No Packing in Transperforation Myringoplasty for Chronic Tympanic Membrane Perforations
Zhengcai Lou1, Zihan Lou2,3,4,5, Zhengnong Chen2,3,4,5
1Department of Otorhinolaryngology, Wenzhou Medical University Affiliated Yiwu Hospital, Yiwu, Zhejiang, China.
Objective:
To compare the operation times, graft survival and success rates, audiometric outcomes, and complications of patients who underwent transperforation myringoplasty with and without packing but without perforation rimming.
Study Design:
A prospective, randomized controlled trial.
Setting:
A university-affiliated teaching hospital.
Methods:
We conducted a randomized controlled trial that enrolled patients who underwent underlay myringoplasty. No patient underwent perforation rimming. Patients underwent myringoplasty with or without graft lateral packing. The operation times, graft survival and success rates, audiometric outcomes, and complications were compared between the 2 groups.
Results:
Sixty patients with unilateral perforations were included. The mean neovascularization score at postoperative week 2 was significantly higher in the no-packing group than in the packing group (p < .01) but did not differ significantly at postoperative weeks 3 and 4, or postoperative month 3. Neither the graft healing rate (p = .313) nor the perforation closure rate (p = .640) significantly differed between the 2 groups. The mean air-bone gap improved by 8.91 ± 5.45 dB in the packing group and 8.17 ± 1.19 dB in the no-packing group (p = .758).
Conclusion:
The long-term graft success and hearing improvements in transperforation myringoplasty with no rimming of the perforation and no-graft lateral packing were comparable to those in the graft lateral packing group with no rimming of the perforation, with a low incidence of complications. These results may change the traditional practice of packing the external auditory canal and rimming the perforation in underlay myringoplasty, even for all myringoplasty surgery.
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