Evaluation of Factors affecting Surgical Outcome of Tympanoplasty

Document Type : Original

Authors

Department of Otorhinolaryngology, Tabriz University of Medical Science, East Azarbaijan, Iran.

Abstract

Introduction:
Tympanoplasty is a standard procedure to repair tympanic membrane perforation. The aim of this study is to evaluate the results of tympanoplasty (hearing improvement and tympanic membrane closure rate) in patients suffering from chronic perforation of the tympanic membrane by considering the prognostic factors.
 Materials and Methods:
In a prospective study, based on the results of tympanoplasty with temporal graft fascia in 60 patients in the ENT department of the Medical Science University of Tabriz, we evaluated prognostic factors, such as age, sex, smoking, size, and site of perforation, for the outcome of this surgery.
 Results:
The rate of surgical success- integration of the graft- was 93.3%. Improvement of hearing, as demonstrated through audiometry, occurred in 93% of cases. We did not find any factors to be statistically significant to affect surgical outcome.
 Conclusion: 
Even by considering the influence of different factors on the results of a tympanoplasty operation, according to the statistical results of this study, there is not a significant difference in the results of the operation, neither in the health of the tympanic membrane after surgery nor in hearing development.
 

Keywords

Main Subjects

References

1. Acuin J. Chronic suppurative otitis media: burden of illness and management. 1st ed .Switzerland: World Health Organization, Geneva; 2004: 9-10.
2. Malik S, Ashrafi K, Sohail Z, Afaq S, Nawaz A. Determinants of variable hearing loss in patients with chronic suppurative otitis media. Pak J Otolaryngol 2012; 28: 45-7.
3. Bhusal CL, Guragain RP, Shrivastav RP. Frequency dependence of hearing loss with perforations. JNepal Med Assoc 2007; 46(168):180-4.
4. Lima JCBD, Marone SAM, Martucci O, Gonçalez F, Silva Neto JJD, Ramos ACM. Evaluation of the organic and functional results of tympanoplasties through a retro-auricular approach at a medical residency unit. Brazilian journal of otorhinolaryngology 2011; 77(2): 229-36.
5. Pfammatter A, Novoa E, Linder T. Can myringoplasty close the air-bone gap? Otology & Neurotology 2013; 34(4):705-10.
6. Karela M, Berry S, Watkins A, Phillipps JJ. Myringoplasty: surgical outcomes and hearing improvement: is it worth performing to improve hearing? European Archives of Oto-Rhino-Laryngology 2008; 265(9): 1039-42.
7. Shetty S. Pre-operative and post-operative assessment of hearing following tympanoplasty. Indian Journal of Otolaryngology and Head & Neck Surgery 2012; 64(4): 377-81.
8. 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. Clinical Otolaryngology 2005; 30(2): 115-20.
9. Emir H, Ceylan K, Kizilkaya Z, Gocmen H, Uzunkulaoglu H, Samim E. Success is a matter of experience: type 1 tympanoplasty. European archives of otorhinolaryngology 2007; 264(6): 595-9.
10. Lee P, Kelly G, Mills RP. Myringoplasty: does the size of the perforation matter? Clinical Otolaryngology Allied Sciences 2002; 27(5): 331-4.
11. Flint PW, Cummings CW, Haughey BH, Lund VJ, Niparko JK, Richardson MA. Cummings otolaryngology head and neck surgery. 5th ed. Mosby; 2010:1999.
12. Angeli SI, Kulak JL, Guzmán J. Lateral Tympanoplasty for Total or Near‐Total Perforation: Prognostic Factors. The Laryngoscope 2006; 116(9): 1594-9.
13. Bastos Freitas E. Estudo comparativo entre as técnicas medial e lateral de timpanoplastia tipo I quanto ao fechamento da perfuração timpânica, resultado funcional e complicações empregando-se enxerto autólogo de fáscia temporal. São Paulo, 2000 (Doctoral dissertation, Tese (doutorado). Faculdade de medicina da USP.[Links]).
14. Mane R, Patil B, Mohite A, Varute VV. Bilateral type 1 tympanoplasty in chronic otitis media. Indian Journal of Otolaryngology and Head & Neck Surgery 2013; 65(4): 293-7.
15. Raghuwanshi SK, Asati DP. Outcome of Single-Sitting Bilateral Type 1 Tympanoplasty in Indian Patients. Indian Journal of Otolaryngology and Head & Neck Surgery 2013; 65(3): 622-6.
16. Mohamad SH, Khan I, Hussain SM. Is cartilage tympanoplasty more effective than fascia tympanoplasty? A systematic review. Otology & Neurotology 2012; 33(5): 699-705.
17. Iacovou E, Vlastarakos PV,  Papacharalampous G, Kyrodimos E, Nikolopoulos TP. Is cartilage better than temporalis muscle fascia in type I tympanoplasty? Implications for current surgical practice. European Archives of Oto-Rhino-Laryngology 2013; 270(11): 2803-13.
18. Koch WM, Friedman EM, McGill TJ, Healy GB. Tympanoplasty in children: the Boston Children's Hospital experience. Archives of Otolaryngology–Head & Neck Surgery 1990; 116(1): 35-40.
19. Black JH, Wormald PJ. Myringoplasty-effects on hearing and contributing factors. South African Medical Journal 1995; 85(1):41.
20. Pinar E, Sadullahoglu K, Calli C, Oncel S. Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngology-Head and Neck Surgery 2008; 139(3): 386-90.
21. Kageyama-Escobar AM, Rivera-Moreno MA, Rivera-Mendez A. Risk Factors Associated with Failure in Myringoplasty. Gaceta medica de Mexico 2001; 137(3): 209-20.
22. Niculescu B, Vesa D, Tomescu E. Variations of Pre-And Post-Operative Hearing Loss Depending On The Size Of Tympanic Membrane Perforation. Medical interventions 2011; 1(3):236-41.
23. Zhang ZG, Huang QH, Zheng YQ, Sun W, Chen YB, Si Y. Three autologous substitutes for myringoplasty: a comparative study. Otology & Neurotology 2011; 32(8):1234-8.
24. Yung MW. Myringoplasty for subtotal perforation. Clinical Otolaryngology and Allied Sciences 1995; 20(3): 241-5.
25. Kotecha B, Fowler S, Topham J. Myringoplasty: a prospective audit study. Clinical otolaryngology and allied sciences 1999; 24(2):126-9.
26. Perkins R, Bui HT. Tympanic membrane reconstruction using formaldehyde-formed autogenous temporalis fascia: twenty years' experience. Otolaryngology-Head and Neck Surgery 1996; 114(3):366-79.
27. Sarker MZ, Ahmed M, Patwary K, Islam R, Joarder AH. Factors affecting surgical outcome of myringoplasty. Bangladesh Journal of Otorhinolaryngology 2011; 17(2): 82-7.
28. Yung MW. Myringoplasty: Hearing gain in relation to perforation site. The Journal of Laryngology & Otology 1983; 97(01): 11-17.
29. Ahmad SW, Ramani GV. Hearing loss in perforations of the tympanic membrane. The Journal of Laryngology & Otology 1979; 93(11): 1091-8.
30. Jurovitzki I, Sade J. Myringoplasty: long-term followup. Otology & Neurotology 1988; 9(1):52-5.
31. Frade GC, Castro VC, Cabanas RE, Elhendi W, Vaamonde LP, Labella CT. Prognostic factors influencing anatomic and functional outcome in myringoplasty. Acta otorrinolaringologica Espanola 2002; 53(10): 729-35.
32. Albera R, Ferrero V, Lacilla M, Canale A. Tympanic reperforation in myringoplasty: evaluation of prognostic factors. Annals of Otology, Rhinology & Laryngology 2006; 115(12): 875-9.
33. Cantrell RW. Myringoplasty failure related to smoking: a preliminary report. Otolaryngologic clinics of North America 1970; 3(1): 141.
34. Becvarovski Z, Kartush JM. Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI). The Laryngoscope 2001; 111(10):1806-11.
 
Iranian Journal of Otorhinolaryngology
Volume 28, Issue 2 - Serial Number 2
March and April 2016
Pages 99-104

Files

Share

How to cite

Statistics