Results Of Tympanoplasty Research Articles

Management of large tympanic membrane perforations – A comparative study

Abstract Background: This study aimed to compare the results of tympanoplasty with temporalis fascia graft alone and with composite graft in cases of inactive mucosal-type chronic suppurative otitis media with subtotal and total perforations in graft uptake and hearing improvement. Methods: It is a prospective case–control study done in in our teaching hospital at Tirupati, in the Department of Ear, Nose and Throat. This study includes 30 patients who are divided into two groups by simple randomisation. Results: In the present study, the graft uptake rate when using only the temporalis fascia was 80% and that in the cartilage and temporalis fascia was 93.34%. Significant hearing improvement (>10 dB) was observed in 75% of patients in the temporalis fascia graft alone group and 71.4% in the composite graft group. There was a mean improvement in air conduction from pre-operative to post-operative in the tympanoplasty with temporalis fascia of 14.4 dB and in the tympanoplasty with composite graft group of 15.06 dB. Conclusions: In the case of large tympanic membrane perforations, the composite graft using the temporalis fascia graft along with conchal/tragal cartilage is superior to the temporalis fascia graft alone, with better graft uptake. However, hearing improvement was better in the group in which only the temporalis fascia graft was used.

Aditus ad antrum patency on CT as a predictor of tympanoplasty outcomes in chronic otitis media

To evaluate the prognostic significance of aditus ad antrum patency, as determined by computed tomography (CT), on the surgical outcomes in patients with chronic suppurative otitis media (CSOM). This study analyzed CSOM patients who had tympanoplasty at a tertiary hospital from 2015 to 2019. Patient demographics, operative reports, preoperative CT scans and outcomes were reviewed. Aditus ad antrum patency was evaluated on CT images. Outcome measures included graft success and postoperative air-bone gap (ABG) at the last follow-up (≥ 6 months). During the study, 138 patients with CSOM patients were included. Computed tomography (CT) scans revealed a blocked aditus in 37 patients (26.8%). Patients in the patent aditus group demonstrated a significantly better hearing prognosis compared to those in the obstructed aditus group (P = 0.002). In the low- and intermediate-risk subgroups, patients with a blocked aditus exhibited significantly poorer postoperative hearing outcomes compared to those with a patent aditus (P < 0.001). Multivariate logistic regression analysis identified obstructed aditus ad antrum (OR 1.83, 95% CI 1.10–3.04; P = 0.020) and a Middle Ear Risk Index (MERI) score greater than 3 (OR 2.68, 95% CI 1.06–6.75; P = 0.037) as independent adverse prognostic factors for hearing success in patients with CSOM. A patent aditus ad antrum correlates with preoperative dry ear, no middle ear granulation, a well-pneumatized mastoid, and a low MERI score. Preoperative CT showing aditus ad antrum patency may independently predict hearing outcomes and help stratify risk in CSOM patients.

Correlation of middle ear risk indices and hearing outcome in tympanoplasty: a prospective study of chronic otitis media patients

Abstract Background Chronic otitis media is a permanent abnormality of the pars tensa or pars flaccida which is predisposed by a middle ear pathology (Flood, J Laryngol Otol 132:1042–4, 2018). The most important clinical feature is conductive hearing loss. The treatment of choice is reconstructive surgery called tympanoplasty which is performed once the ear is dry to prevent graft failure. There are various risk factors which influence graft uptake and hearing outcome following tympanoplasty. The most important risk factors are ear discharge, presence of cholesteatoma, erosion of ossicles, history of previous surgery or smoking. Middle Ear Risk Index is one such prognostic tool which helps in predicting the outcome following tympanoplasty in patients of Chronic Otitis Media. Objective To correlate middle ear risk indices and hearing outcome in patients undergoing tympanoplasty with/without mastoidectomy. Methodology This study was conducted in the Department of Otorhinolaryngology at KS Hegde Charitable Hospital. Subjects diagnosed with chronic otitis media who underwent tympanoplasty with/without mastoidectomy were included in this study after written informed consent. Details were recorded in the performa. All cases were subjected to Pure Tone Audiometry and findings were recorded. Based on the details, Middle Ear Risk Index was calculated. Three months post-operatively, patients were assessed on parameters such as graft uptake by otoscopy, evaluation of hearing, tinnitus, and any other complaints, and repeat PTA was done. These findings were then evaluated and compared with preoperative findings. All data was tabulated in an Excel sheet and analyzed. Result The study was conducted on 82 subjects diagnosed with Chronic Otitis Media who underwent tympanoplasty with/without mastoidectomy. Subjects were divided into 3 categories according to the Middle Ear Risk Index. Forty-three subjects were in mild category, 29 subjects were in moderate category and 10 subjects were in severe category. Subjects undergoing tympanoplasty with/without mastoidectomy showed statistically significant graft uptake as well as hearing improvement in both left and right ear for all three categories of the Middle Ear Risk Index. Conclusion According to our study, MERI may not accurately predict the outcome in patients under undergoing tympanoplasty with/without mastoidectomy. The individual risk factors of MERI can also be used as prognostic indicators. It was observed that external factors such as sterility and post-operative care as well as the patient’s own hygiene practices greatly influenced the outcome of tympanoplasty.

Results of tympanoplasty and its association with the Middle Ear Risk Index in a tertiary care hospital

Abstract OBJECTIVES. To assess the association between tympanoplasty outcomes and the Middle Ear Risk Index (MERI). MATERIAL AND METHODS. Observational, retrospective, analytical, and cross-sectional study. The files of the operated cases were reviewed, and demographic, clinical and MERI parameters were included. Descriptive statistics and measures of dispersion were used. To assess associations, Pearson’s chi-square test was applied, with a significance level set at p ≤ 0.05. RESULTS. A total of 82 files were included, with an average age of 43.12±16.9; 67% of the patients were women and 51.2% had comorbidities. The most used technique was overlay in 76.8%, with the temporal fascia being the most frequently used graft in 81.7%. The degree of middle ear disease was mild in 41 patients (50%), moderate in 28 (34.1%), and severe in 13 ears (15.9%). An association was found between the degree of MERI and surgical success, with a p -value of 0.02. CONCLUSION. It seems that the index is associated with the graft outcome at 6 months. Moderate MERI appears to be linked to lower success rates.

Assessment of Eustachian Tube Dysfunction in Tubotympanic Type of Chronic Otitis Media Patients.

To detect the prevalence of eustachian tube dysfunction in tubotympanic type of chronic otitis media. To correlate eustachian tube dysfunction with surgical outcome of tympanoplasty. This observational study involved 79 patients diagnosed with inactive tubotympanic chronic suppurative otitis media who were planned for type-1 tympanoplasty. The Eustachian tube function preoperatively assessed using the saccharin test, measuring saccharin perception time through otoendoscopic examination. The results were then correlated with graft uptake following tympanoplasty during the follow-up period. This study was conducted over 18 months and sample size was 79. A 68% prevalence of eustachian tube dysfunction based on saccharin perception time was noted. In gross eustachian tube dysfunction category, 8.8% failure rate of tympanoplasty was noted at 3 months follow up.A 1.26% failure rate was noted in partial tube dysfunction. At 6 months follow up period, we noted a graft failure in both gross and partial eustachian dysfunction category which was 11.9% and 3.79% respectively. A correlation among post-operative graft uptake and eustachian tube dysfunction was noted in our study but this was not statistically significant. From our study we noted a high prevalence of eustachian tube dysfunction in CSOM tubotympanic type. Eustachian tube dysfunction is a very common entity that has to be evaluated prior to tympanoplasty surgery. Thus an easy, effective, and cost-effective method like the saccharin test can be used to evaluate eustachian tube function and the surgical outcomes of tympanoplasty as the eustachian tube plays crucial role in middle ear clearance and ventilation. This can guide us to take corrective measures to address the eustachian tube dysfunction.

Comparison of Graft Uptake in Perforated Eardrums with and without Myringosclerosis: A Prospective Case-control Study in a Tertiary Centre.

Introduction Various factors have been reported to affect the rates of success after tympanoplasty, among them, myringosclerosis. However, there are few studies focusing only on the effect of myringosclerotic plaque removal on tympanoplasty outcomes. Objective To compare the outcome of tympanoplasty in perforated eardrums with and without myringosclerosis. Methods The study included patients aged between 21 and 53 years diagnosed at the outpatient department with inactive mucosal chronic otitis media. The sample was divided into the case group, which included subjects with tympanic membrane perforation and myringosclerosis, and the control group, which included subjects with tympanic membrane perforation only, without myringosclerosis. We assessed the audiological findings of the patients before and after surgery, as well as hearing gain, graft uptake, and residual perforation/reperforation. Results No significant relationships were observed involving the age or sex of the patient and the closure rate or hearing gain, neither between the location of the perforation and graft uptake. Graft uptake was higher in patients with perforation size < 50%. The graft uptake and hearing gain were higher in the case group. Conclusion The removal of sclerotic plaques increases the surface of the raw area created by subepithelial excision of the myringosclerotic plaques, leading to a high rate of surgical success for the closure of tympanic membrane defects with coexisting myringosclerosis.

Age-Related Impact on Tympanoplasty Results in Adult Individuals: Prospective Observational Study.

Tympanoplasty is the surgical treatment of Chronic Otitis Media and it aims to eradicate the middle ear disease and provide better hearing to the patient. 'Does age of the patient impact the outcome of tympanoplasty?' is a valid question concerning every otologist. The result of this study will highlight the success rate of graft uptake and hearing improvement with respect to different age groups. To determine if age of the patient is a factor influencing the success rate of Tympanoplasty based on the following parameters:-Graft Uptake, Post operative Hearing gain. A prospective observational study was conducted on 44 patients who underwent underlay Tympanoplasty for a dry central perforation with conductive hearing loss. Pure Tone Audiogram was done pre-operatively. The post-operative Pure Tone Audiogram was repeated three months after the surgery and was compared with the pre-operative PTA. The status of graft uptake was checked 3months post-operatively. It was observed that the graft uptake rate was the least in the age group of 51-65years and decreased when the age of the patient was 36-50years. The graft uptake rate was the highest in patients between 18 and 35years of age. The hearing gain was maximum when the age of the patient was between 18 and 35years and gradually decreased as the age of the patient increased to 36-50years and was the least when the age of the patient was between 50 and 65years. The graft uptake rate was higher in the younger patients than the older patients. All cases show noticeable increase in hearing improvement following tympanoplasty. However, with the advancing age of the patient the post-operative hearing improvement decreased. Thus, 'age of the patient' impacts the success rate of tympanoplasty.

Audiological Outcome of Tympanoplasty With Mastoidectomy in Middle-Aged and Younger Patients With Chronic Otitis Media.

Chronic otitis media (COM)is characterized by chronic, intermittent, or persistent discharge through a perforated tympanic membrane. In this study, we aimed to evaluate the postoperative audiological outcomes in middle-aged patients compared to younger patients who underwent tympanoplasty with mastoidectomy via post-auricular approach for the treatment of COM. This prospective interventional study included patients admitted in wards from August 2017 to January 2019 at the Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh, India. A total of 70 patients diagnosed with COM were enrolled and divided into two groups. Group A(middle-aged COMgroup) included patients41 to 60 years of ageand Group B (younger COM group) consisted of patients 21 to 40 years of age. Patients were followed up for a period of approximately six to nine months to assess the audiological status evaluated at three, six, and nine months after surgery. It was found that after three, six, and nine months post-surgery, the difference in the mean audiological gain was not statistically significant, with p-values at 0.3034, 0.3271, and 0.2923, respectively. The audiological gain demonstrated a slight decrease over time in both groups. Audiological improvement, measured as the mean audiological gain, demonstrated a slight decrease over time in both groups. However, there was no significant difference in the improvement of the air-bone gap between middle-aged and younger patients.

Outcomes of Microscopic vs. Endoscopic Tympanoplasty at a Tertiary Healthcare Institution in Western Maharashtra.

Introduction Chronic suppurative otitis media (CSOM) involves tympanic membrane perforation and is traditionally treated with microscopic tympanoplasty. Recent advancements in endoscopic techniques offer enhanced visibility and outcomes. This retrospective study compares endoscopic and microscopic tympanoplasty outcomes in CSOM patients between 2023 and 2024. Aim This study aims to evaluate outcomes of endoscopic vs. microscopic tympanoplasty in patients suffering from CSOM who are presenting at our tertiary care center. Methodology A retrospective study of 100 patients of CSOM undergoing tympanoplasty. Sixty patients underwent microscopic tympanoplasty and 40 endoscopic tympanoplasty. Postoperative successful uptake of graft and resultant hearing were compared between the two groups. Results Ninety-seven out of 100 patients had a successful graft uptake at three months. Fifty-eight patients in the microscopic tympanoplasty group (96.67%) and 39 in the endoscopic group (97.5%) had healed the tympanic membrane at three months of follow-up (p = 0.864). At postoperative three months, no statistically significant difference was found in the improvements in air conduction levels of the two groups (p = 0.995). No significant difference in the air-bone gap between the two groups (p = 0.095). The average air-bone gap at three months postoperative was 7.95 ± 4.20 decibel (dB) in the microscopic tympanoplasty group and 7.80 ± 4.10 dB in the endoscopic tympanoplasty group (p = 0.680). The incidence of postoperative wound area pain, numbness, and ear discharge was significantly higher in patients undergoing microscopic tympanoplasty (p < 0.05). Conclusion The two methods did not significantly differ in terms of the outcome of the hearing test or the rate of graft uptake. However, a better result was noted in endoscopic tympanoplasty compared to the microscopic tympanoplasty group. Postoperative complications encountered were less in the endoscopic tympanoplasty group.

A Comparative Study of Outcomes of Tympanoplasty with Mastoidectomy Between Middle-Aged and Younger Patients with Chronic Otitis Media

A Comparative Study of Outcomes of Tympanoplasty with Mastoidectomy Between Middle-Aged and Younger Patients with Chronic Otitis Media

Study of Predictive Value of Middle Ear Risk Index on Hearing Improvement in Patients Undergoing Surgery for Chronic Suppurative Otitis Media

Introduction: Middle ear risk index is one of the most reliable measuring tools to predict and evaluate the results of tympanoplasty. This study was done to analyse the predictive value of revised middle ear risk index on hearing improvement in patients undergoing surgery for chronic otitis media and to correlate the association between each index factor with hearing results. Materials and Methods: This prospective observational study was done over 2 years in a tertiary care Army Hospital with 88 patients in the age group of 10-65 years. Preoperative hearing thresholds and air-bone gaps were recorded. Patients were assigned to mild, moderate and severe groups with risk index scores. Hearing thresholds were assessed at 3 and 6 months following surgery for chronic otitis media. Data was statistically analysed. Results: 92.04% and 77.27% showed hearing improvements, 4.54% and 1.13% had deterioration and 3.40% and 21.59% had no change when compared to preoperative results in AC and BC thresholds respectively. 57.95% had post-operative closure of air bone gap of ≤ 12. Compared to cases with AB gap closure ≤ 12, those with AB gap closure &gt; 12 showed statistically significant gain in BC by 0.2dB. Each unit increase in risk index score was associated with statistically significant increase of 0.64 dB in BC. Out of the seven individual factors, only perforation and previous surgery showed statistical significance in terms of hearing improvement. Conclusion: Middle ear risk index is not a good predictor of hearing improvement in ear surgery. Individually, risk index or air bone gap are not strong predictors but jointly, they show strong association with hearing improvement both in terms of AC and BC. Keywords: Middle ear risk index; Air conduction; Bone conduction; Air-bone gap; Hearing improvement.

The Role of the Middle Ear Risk Index in the Outcome of Tympanoplasty in Terms of Graft Uptake and Hearing Improvement

The Role of the Middle Ear Risk Index in the Outcome of Tympanoplasty in Terms of Graft Uptake and Hearing Improvement

Reply to Ronsivalle, S.; Di Luca, M. Exploring the Choice of Graft Materials in Tympanoplasty: A Perspective on the Use of Temporalis Fascia and Cartilage Grafts. Comment on "Ferlito et al. Type 1 Tympanoplasty Outcomes between Cartilage and Temporal Fascia Grafts: A Long-Term Retrospective. J. Clin. Med. 2022, 11, 7000".

We sincerely appreciate the valuable insights Ronsivalle et al [...].

Exploring the Choice of Graft Materials in Tympanoplasty: A Perspective on the Use of Temporalis Fascia and Cartilage Grafts. Comment on Ferlito et al. Type 1 Tympanoplasty Outcomes between Cartilage and Temporal Fascia Grafts: A Long-Term Retrospective Study. J. Clin. Med. 2022, 11, 7000.

I am writing this letter to discuss and share my thoughts on the recently published research comparing the outcomes of using temporalis fascia and cartilage grafts in type I tympanoplasty [...].

Effectiveness of middle ear risk index (MERI) in outcome of tympanoplasty

Effectiveness of middle ear risk index (MERI) in outcome of tympanoplasty

Comparison of the Impacts of Different Middle Ear Mucosal Conditions on Type I Tympanoplasty Outcomes.

This study aimed to explore the impacts of different middle-ear mucosal conditions on the outcomes of type I tympanoplasty. A retrospective analysis of 164 patients with chronic otitis media was carried out. The patients were divided into 4 groups according to their mucosal condition. Preoperative hearing levels and air-bone gap (ABG) before and after surgery were compared via the Kruskal‒Wallis H test. The chi-squared test and Fisher's exact test were used to assess the postoperative complications and impact factors of functional success. Preoperatively, neither the air conduction nor bone conduction values differed significantly among groups with different mucosal conditions. All of the ABG closed dramatically after type I tympanoplasty (P < .05) regardless of the mucosal conditions. The functional success rates were lower when the intratympanic mucosa was moderately or severely edematous compared with mildly edematous or normal (P < .05). The disease course, perforation site, and perforation size, as well as the status of the opposite ear, were not related to the auditory functional outcome. The differences in postoperative reotorrhea and reperforation among the 4 groups were not statistically significant. Preoperative hearing levels were not affected by middle-ear mucosal conditions. The functional success rate was influenced by mucosal conditions, but hearing levels were significantly enhanced after surgical intervention regardless of the mucosal status. Postoperative complications were not related to the mucosal conditions. Thus, type I tympanoplasty is adoptable for mucosal abnormalities when pharmacotherapy cannot result in a healthy tympanum.

Surgical Outcomes of Tympanoplasty with Various Graft Materials in Chronic Otitis Media: A Retrospective Cohort Study

Introduction: Chronic Otitis Media (COM) is a common ear disorder that predominantly affects underdeveloped countries. It is characterised by persistent middle ear discharge and a perforated Tympanic Membrane (TM). Management typically involves antibiotics and surgical techniques like tympanoplasty to eradicate infections and improve the auditory conduction system. Various graft materials are used, with temporalis fascia being preferred due to its proximity and ease of harvesting. Aim: To evaluate the surgical outcomes of tympanoplasty procedures utilising different graft materials in patients diagnosed with inactive mucosal COM. Materials and Methods: This retrospective cohort study was conducted in the Department of Otorhinolaryngology at Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, Maharashtra, India, between June 1, 2013, and May 31, 2023. A total of 165 participants with inactive mucosal COM, who had small to subtotal central perforations of the TM, were included. Tympanoplasty, performed by the same surgeon using the Zeiss surgical microscope model OPMI under general anaesthesia, was the chosen surgical procedure. All cases were executed using the postauricular approach with the underlay technique. A successful anatomical outcome was defined as an intact neoTM without residual perforation at the end of a three-month follow-up. Results: The age of participants ranged from 10 to 75 years, with a mean age of 32.45±14.06 years. The age group most frequently affected by mucosal COM was between 31-40 years, comprising 41 (24.85%) cases. Large perforations were observed in 79 (47.88%) patients, followed by moderate perforations in 65 (39.39%) patients. Normal ossicular chains were found in 163 (98.78%) patients, while ossicular erosion was noted in 2 (1.22%) patients during surgery. A total of 118 (100%) patients who came for follow-up, 84 (71.19%) who underwent temporalis fascia graft reconstruction showed successful graft uptake. Conclusion: This study found that both fascia and cartilage tympanoplasty are suitable for TM repair due to their availability.

Comparative Study of the Outcome of Tympanoplasty Alone with Tympanoplasty Combined with Cortical Mastoidectomy in Patients with Quiescent Mucosal Chronic Otitis Media

ABSTRACT Aims: 1. To compare the outcome of tympanoplasty alone with tympanoplasty combined with cortical mastoidectomy in patients with quiescent Chronic otitis media (COM). 2. To assess gain in hearing in dB. Materials and Methods: Patients diagnosed with mucosal type of chronic otitis media in the quiescent stage were selected. Two groups were formed. Patients were selected randomly and alternately they were included in groups A and B. The patients underwent otomicroscopy. Pure tone audiometry would depict pure conductive hearing of hearing loss. Group A (50% patients) were subjected to tympanoplasty alone and group B (other 50% patients) were subjected to tympanoplasty combined with cortical mastoidectomy. Prior to surgery, all patients underwent routine blood and urine examination, pure tone audiometry, and B/L mastoid X-ray Schuller’s view. Results: In our study, hearing gain in decibels in the tympanoplasty group was 17.1% and in tympanoplasty combined with cortical mastoidectomy was 21.1%. Graft uptake was 94% in the tympanoplasty group and 96% in tympanoplasty combined with cortical mastoidectomy. Recurrence of discharge was seen in three cases of tympanoplasty. Though tympanoplasty combined with cortical mastoidectomy is better in hearing improvement, graft uptake but the difference in two groups is statistically insignificant. Conclusion: Hearing improvement and graft uptake were statistically insignificant in two groups. Combining cortical mastoidectomy with tympanoplasty will not give additional benefits in terms of hearing gain and graft uptake in patients with quiescent mucosal chronic otitis. Media: Clinical significance: Hearing improvement and graft uptake were statistically insignificant in two groups. Combining cortical mastoidectomy with tympanoplasty will not give additional benefits in terms of hearing gain and graft uptake in patients with quiescent mucosal chronic otitis media.

Radiological Anatomy of Eustachian Tube and its Correlation with Graft Uptake in Type I Tympanoplasty

Introduction: Eustachian tube (ET) also known as pharyngotympanic tube connects nasopharynx with the middle ear. Evaluation of ET anatomy is aimed in patients with chronic otitis media. Materials and Methods: In a study of 53 patients, HRCT Temporal bone was done on 128 dual source simens somatom definition flash machine on 5mm cut section and tympanoplasty was carried out. Results: ET angle is one of the important factors for middle ear aeration. Outcome of tympanoplasty at 12th week was 88.7%. In the patients with vertical Eustachian Tube (i.e., more Eustachian Tube angle with the horizontal plane), better graft uptake in tympanoplasty was observed which was statistically significant. However, graft uptake did not correlate with the length of the Eustachian tube. Conclusion: It was concluded that on measuring ET length on HRCT, majority of the patients had bony length of 10-12 mm, cartilaginous length of 15-19 mm and total ET length of 28-32 mm. Majority of the patients had ET angle of 21-30 degrees with the hard palate.

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis.

To compare postoperative tympanoplasty outcomes between active versus inactive otitis media (OM) patients with tympanic membrane perforation. Medline via PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for studies published from inception to March 1, 2023. Studies of 15- to 60-year-old patients undergoing microscopic/endoscopic myringoplasty using underlay/overlay technique with reported postoperative mean hearing gain and graft uptake were included. Studies requiring simultaneous surgical procedures, reporting patients with comorbidities and with non-English full text articles were excluded. Articles were independently screened by two researchers with data extracted according to a predetermined proforma in Microsoft Excel. Cochrane risk-of-bias assessment was used for risk of bias evaluation of randomized studies and Risk of Bias in Nonrandomized Studies of Interventions for nonrandomized studies. Similar studies were pooled for meta-analysis using the inverse variance random effects model to calculate the mean difference and corresponding 95% confidence interval (CI) for mean hearing gain and DerSimonian and Laird random effects model for graft uptake. Thirty-three studies comprising 2,373 patients met the inclusion/exclusion criteria, seven were pooled for meta-analysis. Included articles showed inactive OM patients have higher average postoperative mean hearing gain of 10.84 dB and graft uptake of 88.7% compared to active OM patients (9.15 dB and 84.2%). Meta-analysis of mean hearing gain (MD, -0.76 dB; 95% CI, -2.11 to 0.60; p = 0.27, moderate certainty) and graft uptake (OD, 0.61; 95% CI, 0.34-1.09; p = 0.10, moderate certainty) have an overall p value >0.05. There were no statistically significant differences in postoperative mean hearing gain and graft uptake between active and inactive OM patients undergoing tympanoplasty. Hence, tympanoplasty procedures should not be postponed solely because of patients' preoperative ear discharge status.