Myringoplasty for Marginal Tympanic Membrane Perforation

DING Qunhui; CAI Xunhua; PAN Chenfei; CHEN Wenwen

doi:10.3969/j.issn.1672-2922.2014.04.021

Abstract：Objective To report results of myringoplasty for tympanic membranes with marginal perforations. Methods Thirty nine cases (48 ears) treated between 2006 and 2013 were reviewed, including 19 males (mean age=50.92 years, rang?ing from 26 to 83 years) with a mean disease course of otitis media of 12.5 years. All patients presented with tympanic mem?brane perforation affecting part or the entire rim. Mean pre-operation air-bone gap (ABG) was 30.16 ± 8.76 (13-55) dB, with mean air conduction (AC) threshold at 43.64±11.03(22-72)dB HL and mean bone conduction (BC) threshold at 13.68±9.47 (1-39)dB HL. Key surgical techniques included preservation of skin flap anterior and inferior to the tympanic membrane and application of periosteum graft medial to the tympanic membrane. Disturbance to the ossicles and use of drilling were mini?mized to prevent sensorineural hearing damage. Results All 39 cases were followed up for over 12 months and showed healed perforations. There was no postoperative facial palsy, vertigo or tinnitus. Post-operation AC was 27.56 ± 12.19 dB HL with a GAP of 12.39 ± 8.54 dB, significantly improved compared with pre-operative (U= 6.77 and 10.06, respectively, >u 0.01, p<0.01). Post-operation BC was 13.9 ± 9.95 dB HL, similar to pre-operative (U=0.11,<u 0.05, p>0.05). At follow up, ABG was 10 dB or less in 23 ears(48%), and between 11 and 20 dB in 16 ears(33%);and AC was at 40 dB HL or less in all but 5 ears (10%). Conclusion With appropriate techniques, repair can be completed successfully with satisfactory results for tympanic membrane perforation with completely or partially missing rim.