A prospective comparative study on the short-term effect of endoscopic myringoplasty in dry and wet ears

Abstract

Objective:To investigate the success rate, dry ear time and hearing improvement of myringoplasty on chronic suppurative otitis media（CSOM） patients under dry and wet ear conditions. Method:Patients with CSOM who underwent endoscopic type Ⅰ tympanoplasty between January 2018 and October 2019 in West China Hospital were prospectively enrolled. Before the operation, Ear HRCT, oto-endoscope and pure tone audiometry were completed. According to whether there was mucus and purulent secretion of middle ear accompanied with edema of tympanic mucosa, patients were divided into wet ear group（32 cases） and dry ear group（69 cases）. All patients were followed up at half-month, 1 month and 3 months after surgery, with assessment of endoscopy and pure tone audiometry. SPSS 19.0 was used to compare the therapeutic effect of myringoplasty on different condition CSOM patients. Result:Compared with wet ear group, a higher level of perforation healing rate was found in dry ear group, but there was no significant difference between them（97.1% vs. 90.6%, P=0.367）. The rate of dry ear was 98.6% and 93.7% in dry ear group and wet ear group respectively within three months after surgery, among which the rate of dry ear was 14.5%, 52.2% and 31.9% in dry ear group in half month, 1 month and 3 months after surgery, while that in wet ear group was 28.1%, 40.6% and 25.0% respectively. There was no significant difference in the time to dry ear after surgery between the two groups（P=0.172）. Meanwhile, changes of air bone gap（ABG） between pre-operation and 3 months after operation in dry and wet ear groups was similar [（9.87±1.08） dB vs. （12.74±1.77） dB, P=0.154]. When included patients were analyzed as a whole, the ABG at 3 months was significantly lower than 1 month after operation（P<0.01）, similar result was also found when compared the ABG at 1 month after operation with pre-operation（P<0.01）. The air conduction threshold was improved from （42.09±1.74） dB HL before operation to （29.41±1.61） dB HL at 3 months after operation（P<0.01）, however, there was no significant change in bone conduction threshold（P=0.338）. Conclusion:There is no significant difference in the therapeutic effect of myringoplasty on CSOM patients under dry and wet ear conditions. Direct type Ⅰ tympanoplasty on wet ear patients has no adverse effect on the prognosis.