Graft uptake rates with isoamyl-2-cyanoacrylate in myringoplasty procedures: a 10-year retrospective study.

OBJECTIVE

To assess graft uptake rates with the use of cyanoacrylate adhesives in myringoplasty procedures.

STUDY

DESIGN

Case series with chart review. Setting. Tertiary care center.

SUBJECTS AND

METHODS

Five hundred forty-two patients selected with safe central perforations were divided into 4 groups based on perforation size and each divided into 2 subgroups depending on the presence or absence of preexisting pathology on the remnant tympanic membrane. Myringoplasty without ossicular reconstruction was done postaurally or by transcanal approach, with inlay graft placed and adhesive applied. Ear pack was removed on the seventh postoperative day. Graft uptake rates, graft uptake time (neotympanum intact and mobile), and postoperative sequelae were noted.

RESULTS

Graft uptake was about 99% at 3 months postsurgery. Residual perforation was seen in 2 patients in group 2 and 1 in group 4 and thinned-out tympanum in 1 patient in group 4. Mean uptake time was 21 days. Neotympanum mobility was sluggish in 9 cases postoperatively in group 4 and in 2 cases in group 3. Patients with successful (neotympanum intact and mobile) graft uptake showed significant improvement. Postoperative inflammatory signs in the external auditory canal were seen in 3 cases.

CONCLUSION

Cyanoacrylate use in myringoplasty obtains graft uptake rates of 99% compared with most studies, which report 80% to 90%. This also allows removal of the pack by the seventh day, allowing close follow-up of the graft and less patient discomfort. Importantly, it has not interfered with the formation of the neotympanum or compromised hearing improvement.