Assessment of hearing improvement by myringoplasty

Abstract

Myringoplasty means an operation in which the reconstructive procedure is limited to repair of the tympanic membrane perforation. The procedure of Myringoplasty was evolved a century back and since then has progressively improved in its ability to surgically repair the perforation of the tympanic membrane to a high level of accuracy. The present study was done to study the improvement in hearing after Myringoplasty. The present study “Assessment of hearing improvement by Myringoplasty” was carried out with the patients attended the ENT OPD at a tertiray care hospiatal in South India from from 2000 to 2002. Patients attending to ENT OPD with complaints of discharge from the ear and hard of hearing are examined in detail. Patients having hard of hearing, i.e. conductive deafness and a dry perforation were selected. Pre-operative AB gap in small perforation was between 20-30 dB, in majority of moderate central perforation was between 31-40 dB and in subtotal perforation it was between 41-50 dB. Thus we found in our study, that the pre-operative AB gap increased as the size of perforation increased. After myringoplasty operation, the resultant average improvement, i.e., amount of closure of AB gap was 23 dB. In our study, there was no worsening of hearing or sensorineural loss in any case postoperatively. Perforation of the tympanic membrane most commonly arises as a result of otitis media and trauma, usually presenting clinically with conductive hearing loss and recurring otorrhoea. Myringoplasty using the underlay technique with temporalis fascia as graft in an easy technique which gives a high success rate as far as closure of perforation in tympanic membrane and improvement in hearing is concerned with minimal rate of complications.