Abstract
Objective: To assess tympanic membrane (TM) closure rates achieved by 3 operative procedures in simple underlay myringoplasty with fibrin glue (SUM) for TM perforation.
Method: A SUM was performed under local anesthesia under a microscope in patients with perforated TM defects of 50% or less. In those with defects exceeding 50%, we chose a method allowing SUM to be conducted under general anesthesia. A SUM using an endoscope was performed in cases with curved EAC.
Results: A total of 158 ears were treated by SUM. There were 60 ears on which a SUM was performed using an operating microscope under local anesthesia, and complete closure was achieved in 54 (90%). Eighty-four ears were treated by a SUM under general anesthesia, and closure was achieved in 74 (88%). Endoscopy (1.9 mm in diameter) was performed in 14 ears, of which 13 (93%) attained TM closure. There were no significant differences in closure rates among the surgical procedures selected, and neither enlargement of perforation nor decreased hearing acuity occurred, as compared to the preoperative condition, even in patients suffering reperforation.
Conclusion: This operative procedure is simple and minimally invasive, and provides a satisfactory perforation closure rate. The present data indicate that selection of operative procedures appropriate to various disease states may permit greater extension of surgical indications.
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