Tympanic reperforation in myringoplasty: evaluation of prognostic factors.
OBJECTIVE
The most frequent failure in myringoplasty is reperforation. This complication appears at a rate of 7% to 27%. The aim of this study was to evaluate the importance of the principal prognostic factors to the risk of reperforation.


METHODS
This is a study of prognosis based on an inception cohort. The prognostic factors considered in the study refer to clinical and surgical aspects; follow-up ranged from 5 to 7 years (mean, 68 months). The study was performed on 212 patients with or without otorrhea who underwent operation for tympanic perforation. All subjects underwent myringoplasty by means of an underlay or overlay technique depending on the size and site of the perforation.


RESULTS
Healing of the tympanic perforation was obtained in 182 cases (86%). Age, otorrhea, status of the contralateral ear, and conductive hearing loss did not significantly affect the outcome of surgery. On the other hand, time from surgery, the site of perforation, the type of anesthesia, the approach, the surgical technique, and the type of graft were significantly related to the outcome.


CONCLUSIONS
In the analysis of our results, the surgical approach proved to be the principal prognostic factor in the anatomic outcome of myringoplasty. The results obtained suggest that the principal factors influencing the outcome of myringoplasty are technical and not clinical.
Albera
Roberto
R
Division of Clinical Physiopathology, Department of Otorhinolaryngology, University of Turin, Turin, Italy.
Ferrero
Vittorio
V
Lacilla
Michelangelo
M
Canale
Andrea
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000772:Anesthesia, Local; D002558:Cerebrospinal Fluid Otorrhea / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005205:Fascia / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D018058:Tympanic Membrane Perforation / Q000601:surgery*; D014945:Wound Healing