Myringoplasty in wet and dry ears: an observational study in a tertiary care center

Abstract

<p class="abstract"><strong>Background: </strong>Chronic otitis media is the most common cause of hearing impairment in the developing countries with serious effects. The aim of the study was to compare the outcome of myringoplasty in dry and wet ears in tubo-tympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> This is an observational study done in the department of ENT, Mamata medical college, Khammam, during the study period of September 2019 to February 2021 on 40 patients of tubo-tympanic type COM. On simple random basis selected patients underwent myringoplasty by underlay technique. All patients were evaluated during post-operative follow-up.</p><p class="abstract"><strong>Results:</strong> In our study, majority of patients were in the age group of 26 to 45 years with slight female preponderance, with male to female ratio (0.73:1). In our study, the successful graft uptake was seen 90% in dry ears and 85% in wet ears, which seems to be not significant in difference. With respect to hearing improvement, post-operatively there was significant improvement in both the groups, when compared to pre-operative hearing. The maximum improvement in average hearing threshold after surgery, in dry ears with large perforation (12.66dB) and in wet ears with small central perforation (12.44dB) was almost equal.</p><p><strong>Conclusions: </strong>In this study, the success rate of graft uptake and hearing improvement is found almost equal in dry and wet ears by using underlay technique of myringoplasty. </p>

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

“…We assessed 221 full texts for eligibility as 18 were not able to be retrieved, of which we excluded 188 references. We included 33 studies in the systematic review with full details available in a separate table [Supplementary Content 3, http://links.lww.com/MAO/ B681], of which seven studies with similar study design (7)(8)(9)(10)(11)(12)(13) were included for the meta-analysis. A flowchart of the number of articles included or excluded at each stage is available in Figure 1.…”

“…Thirty-three studies (7-13,18-22,24-44) were included to analyze the outcomes and seven studies (7)(8)(9)(10)(11)(12)(13) were included for the meta-analysis. Twenty studies (60.6%) were undertaken in India, three studies (9.1%) in China, two studies (6.1%) each in Thailand and Bangladesh, and one study (3.0%) each in Korea, Nepal, Iraq, Italy, Egypt, and Pakistan.…”

“…Twenty studies (60.6%) were undertaken in India, three studies (9.1%) in China, two studies (6.1%) each in Thailand and Bangladesh, and one study (3.0%) each in Korea, Nepal, Iraq, Italy, Egypt, and Pakistan. In terms of study design, 13 studies (11,19,20,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) were randomized and 20 (7)(8)(9)(10)12,13,18,21,22,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) were nonrandomized. The inclusion and exclusion criteria of all studies are summarized in Supplementary Content 3, http://links.…”

“…Patient ages ranged from 15 to 60 years old. 23 studies recruited patients with dry ear status (11,(18)(19)(20)(21)(22)(24)(25)(26)(27)(28)(29)(31)(32)(33)35,36,(38)(39)(40)(42)(43)(44), three studies with wet ear status (30,34,37), and 7 studies with both dry and wet ear status (7)(8)(9)(10)12,13,41). Some studies only included microscopic myringoplasty (7-10, 12,13,18-21,24,26,31-33,35,37,40-42), some only endoscopic myringoplasty (27,28,30,34,38,44) and some included both types (11,19,20,(24)(25)(26)(27)(28)(29)…”

“…The prolonged duration of waiting with functional impairment of individuals experiencing conductive hearing loss not only causes decreased quality of life (6) for an extended duration associated with stress and anxiety but also increased financial costs for patients to attend multiple hospital visits. More so, the uncertainty in the outcomes of operating on wet ears increases the waiting times for elective surgery, which could further worsen in the event of another pandemic at the scale of COVID- 19. In the recent years, there has been an increased number of studies (7)(8)(9)(10)(11)(12)(13) comparing of postoperative outcomes among patients with active versus inactive ears; however, due to the lack of meta-analysis on the published data and small sample size of studies, most decisions on whether to operate on an active ear remains heavily dependent on surgeons' preference and respective hospital guidelines.…”