Abstract
The purpose of closure of small dry tympanic membrane perforations is to restore the continuity of the tympanic membrane in order to improve hearing and decrease the incidence of middle ear infections. Small and cost effective procedures like Chemical Cauterization and Fat Plug Myringoplasty have been found to be effective in healing small central perforations with significant hearing improvement. A study was carried out in 69 patients with central perforations in the Department of ENT, Gauhati Medical College & Hospital for the duration of 1 year from August 11 to July 12. Out of 69 patients, 36 underwent Chemical Cauterization and 33 Fat Plug Myringoplasty. Pre-and post-operative hearing assessments of each patient were done and statistically analyzed. The success rate was found to be 83.33% and 90.9% respectively. In both groups, there was statistically significant hearing improvement with a P value 0.01. From our study, it was found that the two procedures are simple, reliable and also lessened the morbidity of the patient. Thus we recommend the use of these two official procedures for the treatment of central perforations of tympanic membrane less than 5 mm.
Highlights
Tympanic membrane perforations result mainly from infectious and traumatic etiologies
In the group that underwent Chemical Cauterization the mean preoperative hearing threshold was 24.66 ± 3.69 and after the procedure the mean hearing threshold was 16 ± 2.03 and there was a mean gain of about 8.66 ± 3.69 dB (Figure 4) which was found to be statistically significant(r = 0.849, p = 0.01)
In the group that underwent Fat Plug Myringoplasty the mean preoperative hearing threshold was 33.83 ± 4.41 and after the procedure the mean hearing threshold was 17.83 ± 2.84 and there was a mean gain of about 16 ± 4.02 dB (Figure 5) which was found to be statistically significant (r = 0.782, p = 0.01)
Summary
Tympanic membrane perforations result mainly from infectious and traumatic etiologies. Perforations result from acute otitis media and trauma heal spontaneously in the majority of cases. Long-standing tympanic membrane perforations may cause conductive hearing loss and middle ear infection even if they are small. The purpose of closure of chronic dry tympanic membrane perforations is to restore the continuity of the tympanic membrane in order to improve hearing and decrease the incidence of middle ear infections. Myringoplasty is the procedure of closure of the perforations of the pars tensa of the tympanic membrane. Tympanoplasty (myringoplasty + ossicular chain reconstruction) is the ideal treatment, simple and cost effective procedures like chemical cauterization and fat plug myringoplasty have been found to be effective in healing small central perforations with significant hearing improvement
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