Role of transtympanic myringoplasty in modern otology.
OBJECTIVE
In this era of bottom-line medicine, transtympanic myringoplasty, although in accordance with the principles of minimally invasive (or access) surgery, is still not popular among otologists. This study evaluates the success rate of transtympanic myringoplasty and defines its role in the current era.


METHODS
A prospective study.


METHODS
Dr. Ram Manohar Lohia Hospital, New Delhi, a tertiary care teaching hospital.


METHODS
The technique was carried out in 25 adult patients with chronic suppurative otitis media-mucosal disease under local anesthesia on the basis of day surgery.


METHODS
An intact graft at the end of the third month was considered a success. A 10 dB hearing improvement in two consecutive frequencies in the range of 500, 1000, 2000, and 3000 Hz was regarded as an audiologic success. Furthermore, the patient's perforations were divided into anterior, inferior, and posterior and the success rate was evaluated in each subgroup. Perforations were also classified into small and medium on the basis of surface area and evaluated statistically on the basis of the Fisher exact test.


RESULTS
An overall success rate of 84% and 71.5% was recorded in terms of perforation closure and hearing improvement. Statistically, the surface area of the perforation did not influence the outcome of the result, but anteriorly placed perforations showed a poor graft uptake.


CONCLUSIONS
From the results herein, we find the technique to be convenient, highly cost-effective, time saving, and patient friendly, with closure rates comparable to other standard techniques of myringoplasty
Singh
Gautam Bir
GB
Department of Otorhinolaryngology and Head and Neck Surgery, Institute of Medical Sciences and Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, Uttar Pradesh, India. gbsnit@yahoo.co.in
Sharma
Arun
A
Singh
Nitasha
N
D000328:Adult; D002908:Chronic Disease; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D008297:Male; D009225:Myringoplasty / Q000379:methods*; D010035:Otitis Media, Suppurative / Q000150:complications / Q000601:surgery; D011446:Prospective Studies; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000150:complications / Q000601:surgery*