Armaghane Danesh Bimonthly Journal (Dec 2012)
Determining the Success Rate of a Modified Underlay Myringoplasty Technique
Abstract
Abstract Background & aim: Chronic otitis media surgery is the most common procedure in the field of otology in developing countries. Subtotal and total tympanic membrane perforation with inadequate anterior remnant is associated with higher rate of graft failure. This study aimed to evaluate the anatomical and functional outcomes of a modified underlay myringoplasty technique. Methods: In the present prospective clinical study, 45 patients with subtotal or total tympanic membrane perforation and inadequate anterior remnant underwent tympanoplasty (+/- mastoidectomy). Anterior tip of the temporalis fascia was secured in a mucosal pocket on the lateral wall of Eustachian tube orifice. Data on graft take rate, preoperative and postoperative hearing status and intraoperative findings were analyzed. The anatomical and functional findings of this procedure were analyzed by paired t-test. Results: A graft success rate of 91.1%, without lateralization, blunting, atelectasia or epithelial pearls was achieved in this study. About 24 % of patients had an air bone gap within 25db before intervention, which increased to 71% postoperatively.(P<0.001). Conclusion: It seems that the current technique could be a convenient and suitable method for cases with subtotal or total tympanic membrane perforation and inadequate anterior remnant. Key words: Tympanic membrane, Perforation, Tympanoplasty, Eustachian tube