Excising or preserving perforation margins in endoscopic transtympanic cartilage myringoplasty does not affect surgical success. (15th October 2021)

• Record Type: Journal Article
• Authors: Lou, Zhengcai; Lou, Zihan; Jin, Kangfeng; Sun, Junzhi; Chen, Zhengnong
• Is Part Of: Clinical otolaryngology. Volume 47:Number 1(2022)
• Page Start: 94
• Page End: 99
• Publication Date: 2021-10-15
• Subjects: cartilage myringoplasty -- chronic otitis media -- chronic tympanic membrane perforation -- mucoepithelial junction -- neovascularisation -- perforation margin; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.13863
• Languages: English
• ISSNs: 1749-4478

Abstract

Abstract: Objective: To compare the outcome of endoscopic transtympanic cartilage myringoplasty with and without removal of perforation edges for repairing chronic perforations with mucosal chronic otitis media (COM). Study design: Quasi‐randomised clinical trial. Setting: Tertiary referral centre. Materials and Methods: Patients with chronic perforations and mucosal COM undergoing endoscopic transtympanic cartilage myringoplasty were allocated to a control group for whom the perforation edges were preserved ( n = 40) and an intervention group for whom the edges were removed ( n = 39). Mean operation time, graft success rate, mean scores of graft neovascularisation and epithelialisation, and hearing were compared between the groups at 4 weeks and/or 6 months postoperatively. Results: Graft success rate was 95% (38/40) in the control group and 97% (38/39) in the intervention group at 6 months postoperatively; the difference was not significant. Mean graft neovascularisation scores 4 weeks postoperatively were 2.52 ± 0.59 in the control group and 2.58 ± 0.55 in the intervention group; the difference was not significant. Mean graft epithelisation scores 4 weeks postoperatively were 1.48 ± 0.57 in the control group and 1.68 ± 0.51 in the intervention group; the difference was not significant and remained nonsignificant 6 months postoperatively (2.5 ± 0.55 vs. 2.76 ± 0.36). Audiological outcomes at 6 months did not differ between the groups. Conclusion: Endoscopic, transtympanic cartilage underlay myringoplasty with preservation of the perforation margins did not affect graft neovascularisation, epithelialisation or success. Longer‐term outcomes and risk of cholesteatoma require further study.