A Myringoplasty Healing Rate and Hearing Outcomes Comparison between Traumatic Tympanic Membrane Perforation and Perforation following Simple Chronic Suppurative Otitis Media

Objective To retrospectively analyze the healing rate and hearing improvement after myringoplasty for traumatic tympanic membrane perforation or perforation from simple chronic suppurative otitis media. Methods Data from 73 patients who received the first myringoplasty in our department between July 2008 and July 2011 were reviewed, including 19 patients (20 ears) with traumatic tympanic membrane perforation and 54 patients (55 ears) with simple chronic suppurative otitis media. The tympanic membrane was examined using an electric endoscope and pure tone audiometry performed before and 3 months after the surgery. The mean air-bone gap (ABG) at 500, 1000, 2000 and 4000 Hz was calculated. Results Tympanic membrane healing rate was 70.00% (14/20) in traumatic tympanic membrane perforation, and 92.73% (51/55) in simple chronic otitis media (P=0.03). Age, size of perforation or surgical technique (underlay or overlay) did not affect the healing rate. Mean ABG in 14 ears with healed traumatic tympanic membrane perforation was 17.85±6.15 dB preoperative and 10.58±5.99 dB postoperative. Mean ABG in 51 ears with healed perforation in simple chronic otitis media was 23.35±9.76 dB preoperative and 14.28±10.53 dB postoperative. Postoperative hearing was improved significantly in both groups ( p 0.05). Conclusion The myringoplasty success rate is lower in traumatic tympanic membrane perforation than in simple chronic suppurative otitis media. Potential risks and benefits should be carefully explained to the patient before surgery as hearing loss is often mild in traumatic tympanic membrane perforation.