The effect of tympanic membrane perforation size on repair results in tympanoplasty

Abstract

Background: The history of tympanic membrane grafting dates back to the nineteenth century.

Toenby used a piece of rubber and silver wire then Bick applied a piece of paper to the perforation in 1887.

The real beginning of tympanoplasty was in 1952 by zolner amd wullstien while herrmann described the facsial graft for the first time. 

Tymanic memebrane perforation is one of the most common issues which faces the ENT – HNS doctors in their clinics.

The patient usually should undergo a Myringoplasty to close the perforation using graft.

Perforation size is one of the challenges which could affect the operation outcome in addition to other factors as the presence of tympanic sclerosis especially near to the edges of the perforation , the condition of the middle ear, ear discharge ,etc.

Central perforations are the most perforations and they cause benigning of  chronic otitis media and hearing loss.

Study objectives: To study the Myringoplasty results  according to perforation size useing a fascia and compare with international studies.

Materials and Methods: prospective study in the ENT – HNS department /Almowasat University hospital between 2016 and 2017 on 60 patients with central perforations with different  sizes.

All patients have achieved our study criteria.

All patients have undergone underlay Myringoplasty using fascia graft(Tympanoplasty wullstien type1).

We have studied many variables in addition to compare the graft take results .

All patients were observed for 2 months after surgery.

Results: Graft uptake:83.3%  overall – 100% in small perforations – 60% in subtotal perforations .

Conclusion: There was a statistically significant  difference in the Myringoplasty outcome between patients according to perforation size.

Keywords: Myringoplasty,Tympanoplasty, Perforation Size.