Clinical and economic evaluation of minimally invasive cartilaginous palisade myringoplasty. (2nd January 2018)

• Record Type: Journal Article
• Authors: Michel, Guillaume; Espitalier, Florent; Boyer, Julie; Malard, Olivier; Bordure, Phillipe
• Is Part Of: Acta oto-laryngologica. Volume 138:Number 1(2018)
• Page Start: 10
• Page End: 15
• Publication Date: 2018-01-02
• Subjects: Audiometry -- myringoplasties -- otologic surgical procedures -- clinical otology -- cartilage palisades; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2017.1375154
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Objectives: To test the clinical and audiometric efficacy of a minimally invasive myringoplasty technique, combining cartilaginous palisades while avoiding flap elevation, for small and wide perforations. Methods: Over 4 years, this retrospective study included all patients over 6 years of age presenting an indication for myringoplasty. Several clinical and economic criteria were noted at 7 d, 2 months, 6 months and 2 years postoperative. The main outcome was the absence of perforation 2 years postoperative. The secondary outcomes were an audiometric gain at 6 months and the evaluation of the treatment cost. Results: Thirty patients underwent the minimally invasive technique and 28 patients the technique with an elevation of the tympanomeatal flap. The minimally invasive surgical procedure was shorter ( p = .001). At 2 years, the tympanic closure rate was equivalent (95% versus 89.5%, p = .77). The audiometric gain was similar between the two techniques ( p = .09). From a medico-economic point of view, the minimally invasive procedure was the most effective because it was three times less expensive than the conventional technique with no reduction in efficacy ( p = .02). Conclusion: This quick and easy technique could be developed in an ambulatory setting or even in conditions adapted to consultation.