{Reference Type}: Journal Article
{Title}: Excising or preserving perforation margins in endoscopic transtympanic cartilage myringoplasty does not affect surgical success.
{Author}: Lou Z;Lou Z;Jin K;Sun J;Chen Z;
{Journal}: Clin Otolaryngol
{Volume}: 0
{Issue}: 0
{Year}: Sep 2021 18
{Factor}: 2.729
{DOI}: 10.1111/coa.13863
{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).
METHODS: Quasi-randomised clinical trial.
METHODS: Tertiary referral centre.
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.
CONCLUSIONS: 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.