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-randomized clinical trial.
Setting
Tertiary referral center.
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 neovascularization and epithelialization, 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 neovascularization 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 epithelization 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 neovascularization, epithelialization, or success. Longer-term outcomes and risk of cholesteatoma, require further study.
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