Size-based individualized tympanic membrane repair in elderly patients under otoendoscopy

Area of Science:

• Otolaryngology
• Surgical Innovation
• Geriatric Medicine

Background:

• Tympanic membrane perforation (TMP) is common in the elderly.
• Optimal surgical repair strategies for elderly patients with TMP require further investigation.
• Perforation size is a critical factor influencing surgical outcomes.

Purpose of the Study:

• To evaluate the effectiveness and safety of different surgical methods for TMP repair in elderly patients.
• To correlate surgical technique selection with perforation size.
• To compare outcomes including healing rates, hearing improvement, and complications.

Main Methods:

• Retrospective analysis of 156 elderly patients undergoing TMP repair.
• Patients categorized into three groups based on TMP size (≤2mm, 2-4mm, >4mm).
• Comparison of surgical time, blood loss, healing rate, air-bone gap (ABG), and complications across different surgical techniques (butterfly, tragus cartilage, tragus cartilage-perichondrium composite).

Main Results:

• Group-S (≤2mm) showed significantly lower surgical time and blood loss.
• All groups achieved high tympanic membrane healing rates (87.0%-95.8%) with no significant difference.
• Significant postoperative air-bone gap (ABG) improvement observed in all groups, with greater reduction in smaller perforation groups.

Conclusions:

• Tailoring surgical procedures to TMP size in elderly patients is effective.
• High tympanic membrane healing rates and satisfactory hearing improvement can be achieved.
• The chosen surgical methods demonstrate comparable safety and efficacy for TMP repair in the elderly.