Comparison of paper-patch and Fat Myringoplasty in repair of small Tympanic membrane perforations in Lampang Hospital

Abstract

Abstract :

Background: Patients with small tympanic membrane perforations usually have hearing loss and more chance of middle ear infection, resulting in the complications of otitis media. If patients perceive and understand the causes and symptoms of the disease, they will be aware and focus on signs and symptoms of diseases that finally lead to the proper treatment. Perforations of the tympanic membrane are treated with various surgical techniques and materials, all of which have advantages and disadvantages. Objective: To compare the chance of success in treatment of small tympanic membrane perforations by using paper-patching and fat myringoplasty of patients in Lampang hospital Subjects and Methods: This prospective analytical study has been conducted in 44 patients with small tympanic membrane perforations. The patients were divided into two groups according to surgical procedures, 17 patients had the paper-patch surgery and 27 patients with fat myringoplasty from June 2016 to March 2018. Logistic Regression has been used in this study to compare the success rate of paper-patch and fat myringoplasty. Paper patching myringoplasty is a simple technique performed as an outpatient procedure. Fat myingoplasty is a simple and cost effective technique. The operations were performed in operating room, all cases were done under local anesthesia. Results: Binary logistic regression analysis failed to show any significant difference in success opportunity of both paper patching and fat myringoplasty in repair of small tympanic membrane perforation. Conclusions: There are two factors predicting success in treatment of paper-patching and fat myringoplasty such as timing the ear dries before grafting and the actual size of the perforation of the tympanic membrane. It has been found that the chances of success with both methods are not different in patients with perforations size of 1 to 2 millimeters. Patients with perforations of 3 millimeters, fat myringoplasty is more successful than paper patching. In patients with 4 mm perforation size, the chances of success in treating the tympanic membrane by using paper patch and fat myringoplasty were not significantly different. (However, the penetrating hole is smaller in both two groups.)