Successful Myringoplasty - Do The Site & Size Of TM Perforation Matter?

Abstract

Objective: To determine the success rate of myringoplasty based on the site and size of tympanic membrane perforation. Study Design: Cross sectional, Descriptive Study Settings: ENT Department Fauji Foundation Hospital, Rawalpindi Study Duration: 30 July 2019 to 29 December 2021. Material and Methods: After approval of Hospital Ethical Committee, a sample size of 100 patients was calculated by using WHO sample size calculator. Patients were selected through Non probability convenient sampling. Informed consent was obtained from all the patients. All the patients were operated upon through post auricular approach using underlay technique and temporalis fascia was used as a graft in all the cases. Success of myringoplasty was assessed one month after surgery. Myringoplasty was considered successful upon complete closure of the defect as assessed under surgical microscope. Data analysis was done for frequencies and percentages using SPSS version 24. Results: There were 52% males and 48% females. Mean age of patients was 35.5 years and they ranged between 17 to 48 years. Overall myringoplasty was successful in 71% patients. Regarding the size of perforation, it was successful in 100% pinhead size perforations, in 86.7% small sized, 89.5% medium sized, 42% large and 6.7% subtotal sized perforations. Regarding site of the perforations, myringoplasty was successful in 96% anterior, 100% posterior, 40% inferior, 40% middle and 8% subtotal/ large perforations. Conclusion: Myringoplasty is an effective surgery for sealing Tympanic Membrane perforations resulting in better quality of life. Success rate of myringoplasty has a definite association with size and site of perforation. The smaller the perforation, the higher would be the success rate. Similarly, anterior and posterior perforations heal better as compared to inferior and mid position perforations. Key words: Myringoplasty, Size and site of Tympanic membrane perforation, Tympanic membrane, Chronic Suppurative Otitis Media.