title: Epithelial migration of the postmyringoplasty tympanic membrane.
abstract: OBJECTIVE
  To determine whether the postmyringoplasty tympanic membrane (TM) behaves in a similar way compared with a healthy nonoperated eardrum by calculating and comparing the epithelial migration rate and pattern.
  
  
  METHODS
  Prospective, nonrandomized case-control study. Each subject who has undergone a myringoplasty and with healthy contralateral TM as control is included in this study.
  
  
  METHODS
  Otolaryngology outpatient clinic.
  
  
  METHODS
  A total of 23 subjects with 46 ears have been selected from otolaryngology outpatient clinic of the University Malaya Medical Center after excluding two subjects from this study. The study was conducted from June 2003 to September 2004.
  
  
  METHODS
  All the selected subjects' ears were examined under a microscope. Methylene blue ink dot was applied to the epithelium of the TM at the immediate vicinity of the umbo; then, weekly follow-up was performed until the migratory pattern and the rate of epithelial migration was noted.
  
  
  METHODS
  Direction and rate of epithelial migration in both study and control group were measured and compared.
  
  
  RESULTS
  Epithelial migration did occur in postgrafted TM, from the umbo region toward the ear canal wall in a lateral radiating manner. Most of the patients (19 of 23 patients [82.6%]) showed nearly similar migratory pattern (same direction) in both the control and the study ear. None of the 46 ears showed any evidence of epithelial migration in the anteroinferior direction of TM. The rate of migration was slower in the beginning, especially near the umbo region (almost no movement at the first 1 or 2 weeks after ink dot application). For both groups, the rate of migration increased when approaching the periphery or annulus region. There was not much difference in the mean daily migratory rate between the control and the study ear (93.4 microm/d and 91.7 microm/d, respectively). The mean migratory rate was highest in subtotal perforation (97.2 microm/d) and lowest in small perforations (< 20%; 83.6 microm/d).
  
  
  CONCLUSIONS
  There was no difference in epithelial migration rate and pattern between the postmyringoplasty TM and the healthy TM.
authors.affiliation: Department of Otolaryngology, University Malaya Medical Center, Kuala Lumpur, Malaysia.
authors.forename: Kee Kong
authors.initials: KK
authors.lastname: Deong
authors.forename: Narayanan
authors.initials: N
authors.lastname: Prepageran
authors.forename: Rajagopalan
authors.initials: R
authors.lastname: Raman
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002465:Cell Movement; D004847:Epithelial Cells / Q000166:cytology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000009:adverse effects*; D011183:Postoperative Complications; D011446:Prospective Studies; D012044:Regression Analysis; D014432:Tympanic Membrane / Q000473:pathology*; D018058:Tympanic Membrane Perforation / Q000601:surgery