title: Myringoplasty: a comparison of bismuth iodoform paraffin paste gauze pack and tri-adcortyl ointment ear dressing.
abstract: OBJECTIVE
  To assess the myringoplasty graft take rate, comparing two methods of post-operative ear packing: bismuth iodoform paraffin paste (BIPP) gauze versus tri-adcortyl ointment (TAO).
  
  
  METHODS
  A retrospective study of patients who had undergone myringoplasty at our department within a three-year period was undertaken. Data, including age, site and size of perforation, grade of surgeon, surgical approach, use of post-operative ear dressings, complications, and audiometric outcome, were collected from the patient notes and analysed. The overall success rate of the operation (with success being defined as an intact tympanic membrane at six months) was noted.
  
  
  RESULTS
  One hundred and seventy myringoplasties were performed over the study period, but data were complete on 154 patients and these constituted the study population. Age ranged from nine to 71 years (mean age 34 years) and the mean follow-up period was seven months. Consultants performed 62 per cent of the operations, with an 85 per cent success rate, whereas trainees performed the remaining 38 per cent, with a success rate of 73 per cent (p=0.059). The overall success rate was 80 per cent; 79 per cent for BIPP and 83 per cent for TAO (p=0.55), and 87 per cent for small perforations and 75 per cent for subtotal perforations (p=0.22). There was audiometric improvement in 74 per cent of cases.
  
  
  CONCLUSIONS
  We found no significant difference in outcome between patients packed with TAO and BIPP. Packing with TAO is therefore a suitable alternative to BIPP gauze ear dressing following myringoplasty.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, City Hospital, Birmingham, UK.
authors.forename: V
authors.initials: V
authors.lastname: Nakhla
authors.forename: Y M
authors.initials: YM
authors.lastname: Takwoingi
authors.forename: A
authors.initials: A
authors.lastname: Sinha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001458:Bandages / Q000592:standards*; D001729:Bismuth / Q000627:therapeutic use; D002648:Child; D004338:Drug Combinations; D005260:Female; D006096:Gramicidin / Q000627:therapeutic use; D006801:Humans; D006847:Hydrocarbons, Iodinated / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D009355:Neomycin / Q000627:therapeutic use; D009761:Nystatin / Q000627:therapeutic use; D009824:Ointments / Q000627:therapeutic use; D011182:Postoperative Care; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D018058:Tympanic Membrane Perforation / Q000628:therapy*; D014945:Wound Healing
chemical_list: D004338:Drug Combinations; C014118:Gramicidin, Neomycin Sulfate, Nystatin, Triamcinolone Acetonide Drug Combination; D006847:Hydrocarbons, Iodinated; D009824:Ointments; C045757:bismuth iodoform paraffin paste; D009761:Nystatin; D006096:Gramicidin; D014222:Triamcinolone Acetonide; D009355:Neomycin; D001729:Bismuth