Factors Affecting Myringoplasty Success

Abstract

Objective: A retrospective study in a teaching hospital on all patients who underwent myringoplasty between January 2005 and January 2010 in order to determine the independent factors which significantly affect success in myringoplasty in a pediatric and adult age groups.

Method: Main outcome measures were recurrence of tympanic membrane perforation and closure of the air-bone gap to within 10dbHL. Chi-squared analysis determined the significance of: surgeon grade, condition of the ipsilateral and contralateral middle ear, perforation site and size, and cortical mastoidectomy for both the pediatric and adult groups.

Results: A total of 395 procedures were included. A total of 39 of these were on patients aged ≤ 16 years. Mean overall age: 35.8 years (range, 10-72 years). Mean length of follow-up: 7.5 months (range, 2-48 years). Overall graft take rate was 81%. Graft take in those aged 16 months was 85%. Significant factors in the adult age group were the site of perforation, with anterior perforations associated with the poorest outcome, and simultaneous cortical mastoidectomy (P < .05). These were not significant in the pediatric age group. Perforation size, the condition of the ipsilateral and contralateral middle ear and grade of surgeon were insignificant in both age groups.

Conclusion: It is important for the operating surgeon to have an appreciation of the factors which affect graft take in myringoplasty when deciding to operate and when consenting the patient preoperatively, as these may affect the chance of success.