Tympanoplasty Healing Outcomes With Use of Postoperative Otic Quinolones

Abstract

ObjectiveTympanoplasty usually results in tympanic membrane perforation (TMP) closure, but healing may be suboptimal (e.g., excess scarring). Factors that have been linked to impaired TM healing have become widely adopted (especially, postoperative use of quinolone ear drops). The aim of this study is to assess the frequency of suboptimal tympanoplasty healing with the use of otic quinolones postoperatively.Study DesignRetrospective chart review.SettingTertiary care facility.PatientsOne hundred patients undergoing tympanoplasty for TMP.Intervention(s)Tympanoplasty +/− canalplasty.Main Outcome Measure(s)Healing complications (e.g., granulation tissue, TMP, myringitis, bone exposure, lateralization, anterior blunting, medial canal fibrosis, and canal stenosis) and hearing loss.MethodsCharts were reviewed for postoperative healing issues and hearing outcomes at 1 to 2 years postoperatively.ResultsTMP closure was found in 93.2%, but 34.2% had healing issues at 1 to 2 years postoperatively, with 20.6% having adverse healing outcomes (perforation (6.9%), granulation tissue (6.9%), medial fibrosis (4.1%), and myringitis, bone exposure, and webbing (all 1.4%). Another 13.7% had notable postoperative issues, such as protracted otorrhea (11.0%), otitis externa (9.6%), otitis media (1.4%), and atelectasis (2.7%). No medical, surgical, or patient factors impacted outcomes. Average air–bone gap at 1 to 2 years did not differ between patients with and without healing issues and patients with other postoperative issues (p= 0.5).ConclusionsSuboptimal healing is common after tympanoplasty. There may be significant opportunity to improve post-tympanoplasty healing beyond improving the TMP closure rate.