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Review of endoscopic myringoplasty success: comparisons of intra-operative graft material and post-operative packing in terms of graft failure rate

Published online by Cambridge University Press:  02 February 2022

P M Puttasiddaiah Open the ORCID record for P M Puttasiddaiah [Opens in a new window] ,
S Morris ,
S Browning  and
A Sanu
P M Puttasiddaiah*
Affiliation:
Department of Otolaryngology, Morriston Hospital, Swansea, Wales, UK
S Morris
Affiliation:
Department of Otolaryngology, Morriston Hospital, Swansea, Wales, UK
S Browning
Affiliation:
Department of Otolaryngology, Morriston Hospital, Swansea, Wales, UK
A Sanu
Affiliation:
Department of Otolaryngology, Morriston Hospital, Swansea, Wales, UK
*
Author for correspondence: Mr Paramesh Mankunda Puttasiddaiah, Department of Otolaryngology, Morriston Hospital, Swansea SA6 6NL, Wales, UK E-mail: [email protected]
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Abstract

Background

Myringoplasty success rate is estimated to be between 60 and 90 per cent. Factors predicting success include the choice of graft and use of auditory canal packing. This study aimed to determine the intra-operative factors associated with endoscopic myringoplasty success.

Methods

A retrospective review of all endoscopic myringoplasty cases between January 2017 and January 2020 was undertaken. Data were collected on: patient demographics, tympanic membrane perforation size, intra-operative details, audiology and post-operative outcomes.

Results

There was no significant difference in graft success rates between cases using bismuth iodoform paraffin paste and Spongostan packing (86.7 per cent vs 84.9 per cent, respectively). Conchal cartilage graft had a higher success rate (100.0 per cent) compared with Biodesign grafting biomaterial (66.7 per cent), but was not superior to tragal cartilage (84.6 per cent) or temporalis fat or fascia (80.0 per cent).

Conclusion

Spongostan packing is equivalent to bismuth iodoform paraffin paste in terms of endoscopic myringoplasty success rate. Although conchal cartilage graft had higher success rates, it was not statistically significantly different from tragal cartilage.

Keywords

MyringoplastyBismuth Iodoform ParaffinOtolaryngologyAudiology
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 10 , October 2022 , pp. 994 - 997
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr P M Puttasiddaiah takes responsibility for the integrity of the content of the paper

References

Kotecha, B, Fowler, S, Topham, J. Myringoplasty: a prospective audit study. Clin Otolaryngol 1999;24:126–9CrossRefGoogle ScholarPubMed
Lee, P, Kelly, G, Mills, RP. Myringoplasty: does size of the perforation matter? Clin Otolaryngol 2002;27:331–4CrossRefGoogle ScholarPubMed
Yung, MW. Myringoplasty for subtotal perforations. Clin Otolaryngol 1995;20:241–5CrossRefGoogle Scholar
Onal, K, Uguz, MZ, Kazikdas, KC, Gursoy, ST, Gokce, H. A multivariate analysis of otological, surgical and patient-related factors in determining success in myringoplasty. Clin Otolaryngol 2005;30:115–20CrossRefGoogle ScholarPubMed
Zeitoun, H, Sandhu, GS, Kuo, M, MacNamara, M. A randomized prospective trial to compare four different packs following permeatal middle ear surgery. J Laryngol Otol 1998;112:140–4CrossRefGoogle ScholarPubMed
Lou, Z. The effect of external auditory canal packing duration on healing after endoscopic cartilage myringoplasty. Ear Nose Throat J 2021;100:656–61CrossRefGoogle ScholarPubMed
Anderson, O, Takwoingi, YM. Tri-adcortyl ointment ear dressing in myringoplasty: an analysis of outcome. Eur Arch Otorhinolaryngol 2007;264:873–7CrossRefGoogle Scholar
Nakhla, V, Takwoingi, Y, Sinha, A. Myringoplasty: a comparison of bismuth iodoform paraffin paste gauze pack and tri-adcortyl ointment ear dressing. J Laryngol Otol 2007;121:329–32CrossRefGoogle ScholarPubMed
Javed, F, Whitwell, R, Hajioff, D, Robinson, P, Rea, D, Macleod, I et al. A pilot randomized controlled trial comparing bismuth iodine paraffin paste external ear pack and no ear pack after middle ear surgery. Eur Arch Otorhinolaryngol 2015;272:543–50CrossRefGoogle ScholarPubMed
Shekharappa, MK, Siddappa, SM. Cartilage myringoplasty: an ideal grafting technique for complex perforations. J Clin Diagn Res 2017;11:MC06–8Google ScholarPubMed
Cavaliere, M, Mottola, G, Rondinelli, M, Iemma, M. Tragal cartilage in tympanoplasty: anatomic and functional results in 306 cases. Acta Otorhinolaryngol Ital 2009;29:27–32Google ScholarPubMed
Basonbul, RA, Cohen, MS. Use of porcine small intestinal submucosa for pediatric endoscopic tympanic membrane repair. World J Otorhinolaryngol Head Neck Surg 2017;3:142–7CrossRefGoogle ScholarPubMed
Bennett, AM, Bartle, J, Yung, MW. Avoidance of BIPP allergy hypersensitivity reactions following ear surgery. Clin Otolaryngol 2008;33:32–4CrossRefGoogle ScholarPubMed
Alsanosi, A. Myringoplasty: a comparison of bismuth iodoform paraffin paste gauze pack and plane gauze (containing lococotien with veoform). Int J Health Sci (Qassim) 2009;3:29–31Google Scholar
Ethicon. Spongostan Absorbable Haemostatic Gelatin Powder. In: https://www.jnjmedicaldevices.com/en-EMEA/product/spongostan-absorbable-haemostatic-gelatin-sponge [4 March 2021]Google Scholar
Demirpehlivan, IA, Onal, K, Arslanoglu, S, Songu, M, Ciger, E, Can, N. Comparison of different tympanic membrane reconstruction techniques in type I tympanoplasty. Eur Arch Otorhinolaryngol 2011;268:471–4CrossRefGoogle ScholarPubMed
Zahnert, T, Hüttenbrink, KB, Mürbe, D, Bornitz, M. Experimental investigations of the use of cartilage in tympanic membrane reconstruction. Am J Otol 2000;21:322–8CrossRefGoogle ScholarPubMed
Wasson, JD, Papadimitriou, CE, Pau, H. Myringoplasty: impact of perforation size on closure and audiological improvement. J Laryngol Otol 2009;123:973–7CrossRefGoogle ScholarPubMed