Myringoplasty

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Abstract
Out of 855 myringoplasties performed during the yr 1971-1979, ears (741) were analyzed for early results, and 387 for late results. The operations were performed by experienced surgeons and by senior residents. Only the ears with an underlaid fascia or perichondrium, operated upon for the first time, were included. The analysis was performed with the help of a computer, using SPSS [Statistical Package for the Social Sciences] and Chi-square tests. This showed that side, age, sex and state of the mucosa (as well as the type of graft or post-operative infections) had no significant bearing on the rate of graft take. The bigger perforations and the more anteriorly placed ones, had a less favorable prognosis. Rate of graft take differed from surgeon to surgeon; some senior residents, however, had very favorable results. Graft take was analyzed for 1971-1978 first, when an average initial graft take of 81% was found, the range between surgeons being from 63.5%-93.5%. As a 2nd group myringoplasties performed in 1979 were analyzed when the average graft take rose to 91% and the difference between various surgeons decreased very significantly. The success rate evidently depended on experience and meticulousness, the latter being related to awareness that the results were being computed. Follow-up of .gtoreq. 1 yr of successful cases showed that, with time, small perforations developed once again in 8%; 8.7% showed the appearance of a slight tympanic membrane retraction, and 1.5% severe retraction. In 11% some defect of the covering epithelium appeared; .apprx. 1/2 of these late complications appeared in 1 ear. While there are significant differences in graft take according to the size and place of the perforation, as well as between surgeons, an early average graft take of > 90% could be expected. A 10% rate of some deterioration in cases with early satisfactory results will occur mostly within the first 2 yr post-operatively, irrespective of any factors which can be controlled.

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