Impact of site and size of pars tensa tympanic membrane perforation on the success rate of myringoplasty

Abstract

ObjectiveThis article is intended to investigate the impact of size and site of tympanic membrane (TM) perforation on the outcome and success rate of myringoplasty.Patients and methodsThis prospective study was conducted at Assiut University Hospital, between September 2015 and November 2017. Video-otoscopy was done to all cases, the images were registered on the computer and analyzed by using Universal Desktop Ruler V.3.5.3364 program, as the area of TM perforation (P) and the entire area of TM (T) were calculated. Thereafter, the percentage area of the perforation (P/T×100%) for the perforated ear was revealed. Site of perforation was also authenticated. Preoperative and postoperative A–B gap was carried out through audiogram for hearing results.ResultsThe overall success rate of myringoplasty was 78.8%. According to size of TM perforation; the highest success rate of myringoplasty established between small perforations was 93.3% and the lowest found between subtotal perforations was 42.9%; in medium and large perforations, the success rate of myringoplasty was 87.5 and 71.4%, respectively. As regards the site of TM perforation, the success rate of myringoplasty was highest (90%) for posterior perforations and lowest (70%) for anterior perforations; in central and inferior perforations, the success rate of myringoplasty was 79.8 and 75%, respectively. After myringoplasty, the amount of closure of A–B gap was 21.82 dB.ConclusionThe size of TM perforation has a great influence on the success rate of myringoplasty, while the site of TM perforation has no impact on the success rate of myringoplasty, and myringoplasty is an effective operation for sealing off TM perforations, resulting in improvement of quality of life.