Predictors for outcome of paper patch myringoplasty in patients with chronic tympanic membrane perforations

Park, Shi-Nae; Kim, Hyo-Min; Jin, Kyung-Suk; Maeng, Jae-Hoan; Yeo, Sang-Won; Park, Soyoung

doi:10.1007/s00405-013-2860-y

Cited by 24 publications

(30 citation statements)

References 9 publications

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“…Our success rate is similar to or slightly higher than those in previous reports [1,2,4] . However, our general success rate is lower than that reported by Lou et al [6] In their study, almost 98% of 504 cases with traumatic TM perforations were acute onset (within 1 month after a trauma), and a spontaneous healing rate of 89% cases was reported.…”

Section: Discussionsupporting

confidence: 91%

“…The study by Park et al [4] had a study design and analysis similar to our study. They reported that perforation size was the only outcome predictor of paper patch myringoplasty, although they analyzed predictive factors, including age, sex, affected ear, hearing level, dura- tion of perforation, cause, location and size of perforation, relationship between the perforation border and the malleus, status of TM surface, and number of patch applications.…”

Section: Discussionmentioning

confidence: 77%

“…The candidates of Park et al [4] had chronic perforations lasting for more than 3 months; however, our study included all TM perforations regardless of duration. 2.…”

Section: Discussionmentioning

confidence: 99%

“…Long-standing TM perforations may cause conductive hearing loss and middle ear infection even if they are small. The purpose of the closure of TM perforations is to restore the continuity of the TM to improve hearing ability and decrease the risk of middle ear infection [1][2][3][4] . Although many reports have demonstrated that numerous cases of perforated TM heal spontaneously, several operative interventions can be helpful, particularly for large-sized and peripherally-located perforations [2,4] .…”

Section: Introductionmentioning

confidence: 99%

“…However, these two studies did not include other clinical factors apart from the size of TM perforations as outcome predictors. Park et al [4] reported that the outcome predictor of paper patch myringoplasty was perforation size; however, they evaluated only chronic perforations of more than 3 months, regardless of the cause, and followed up the cases until 3 months.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Analysis of Paper Patch Myringoplasty in Patients with Tympanic Membrane Perforations

Lee¹,

Kim²,

Shin³

et al. 2016

Int Adv Otol

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OBJECTIVE:The aims of our study were to evaluate the outcome of office-based paper patch grafting in tympanic membrane (TM) perforation regardless of the disease duration or etiology and to compare the clinical factors influencing the successful closure of perforation between the success and failure groups of paper patch myringoplasty. MATERIALS and METHODS:This is a retrospective study of 114 patients that underwent paper patch myringoplasty in an outpatient setting (success group, 83 cases; failure group, 31 cases). Thirteen clinical factors with potential impact on the healing status of the TM were investigated: gender, age, laterality, etiology, duration of perforation, tinnitus, hearing loss, otorrhea, size and location of perforation, status of contralateral ear, ipsilateral findings of computed tomography, and duration of complete healing. The follow-up period was at least 1 year. RESULTS:The total success rate of paper patch grafting was 72.8%. The mean age of the failure group was significantly more higher than that of the success group. Significant differences in the etiology as well as in the history of otorrhea were found between the success and failure groups. There were no significant differences for any of the other factors between chronic and non-chronic perforations. CONCLUSION:The predictors of successful outcome were patient's age, etiology of perforation, and history of otorrhea. Clinicians can attempt paper patch myringoplasty first in younger patients, traumatic TM perforation cases, and in patients with no history of otorrhea. Paper patch grafting can also be considered before formal surgical myringoplasty in the case of small, dry, chronic TM perforations.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 77%

“…The candidates of Park et al [4] had chronic perforations lasting for more than 3 months; however, our study included all TM perforations regardless of duration. 2.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Analysis of Paper Patch Myringoplasty in Patients with Tympanic Membrane Perforations

Lee¹,

Kim²,

Shin³

et al. 2016

Int Adv Otol

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A prospective cohort study of the silk fibroin patch in chronic tympanic membrane perforation

et al. 2016

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A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

et al. 2020

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Objectives Nonautologous graft materials may solve several dilemmas in tympanoplasty by obviating the need for graft harvest, facilitating consistent wound healing, and permitting graft placement in the clinical setting. Prior studies of nonautologous grafts in humans have shown variable outcomes. In this systematic review, we aim to 1) summarize clinical outcomes and 2) discuss limitations in the literature regarding nonautologous grafts for tympanoplasty in humans. Methods A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) recommendations. The study size, etiology and duration of perforation, type of nonautologous graft, and postoperative closure rate were assessed. Results The PRISMA approach yielded 61 articles, including 3,247 ears that met inclusion criteria. Studies evaluated nonautologous grafts including paper patch, gelatin sponge, growth factors, porcine small‐intestinal submucosa, among others. Traumatic perforations (62.3%) were most commonly studied, whereas postinfectious perforations (31.9%) and other etiologies (5.8%) comprised a minority of cases. Acute perforations of <8 weeks duration constituted just over half of all treated ears. Overall closure rate was 82.1%, with significantly higher closure rates in acute (89.9%) versus chronic perforations (64.9%, P < .01), regardless of material. A median postoperative air‐bone gap of 5.6 dB was found in the 23% of studies reporting this metric. Conclusions The majority of publications reviewing nonautologous materials in tympanoplasty evaluate acute or traumatic perforations, and few rigorously report hearing outcomes. Given available data, porcine submucosa and basic fibroblast growth factor may hold promise for chronic perforation closure. Future studies should report closure rates and hearing outcomes in perforations >8 weeks duration. Laryngoscope, 131:392–400, 2021

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Predictors for outcome of paper patch myringoplasty in patients with chronic tympanic membrane perforations

Cited by 24 publications

References 9 publications

Clinical Analysis of Paper Patch Myringoplasty in Patients with Tympanic Membrane Perforations

Clinical Analysis of Paper Patch Myringoplasty in Patients with Tympanic Membrane Perforations

A prospective cohort study of the silk fibroin patch in chronic tympanic membrane perforation

A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

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