Prospective study of myringoplasty using different approaches

Abstract

Myringoplasty is one of the various surgical techniques for the management of chronic supurative otitis media of tubotympanic type (CSOM-TT). The presence of a perforation of tympanic membrane with intermittent discharge and hearing loss of conductive nature are the indications of myringoplasty. Myringoplasty can be performed by any of the three approaches, i.e. permeatal, endaural, or post-aural. It is a beneficial procedure done for closing tympanic membrane perforation and improving hearing. The aim of this study was to evaluate and compare different approaches of myringoplasty and various factors influencing surgical outcome. Myringoplasty was done in 90 cases of tympanic membrane perforation with temporalis fascia graft by underlay or onlay technique through one of the three approaches, i.e. permeatal, endaural and post-aural. The overall success rate in this study was 81.11% with majority of patients had improvement in hearing. Statistically there was no significant difference in results with different approaches. Age, sex, site, size and duration of disease had no bearing on graft take in this study. In repairing tympanic membrane perforations similar success rates are achieved with postaural or endaural approaches. A permeatal approach is most limited in the exposure obtained. What is important in choosing the appropriate approach is the location and size of the perforation and size of external auditory canal.