Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026
Comparison of Myringoplasty Outcomes Among External Auditory Canal Packing, Blood on the Graft Surface, or No External Auditory Canal Packing for Chronic Tympanic Membrane Perforation: A Randomized Study.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Lou Zhengcai, Yang Hailing
Аннотация
OBJECTIVE: The objective of this study was to compare graft outcomes and complications of myringoplasty among external auditory canal packing (EAC) with Nasopore, blood on the graft surface, and no EAC packing.
MATERIALS AND METHODS: Patients with chronic perforation were randomly allocated to the EAC packing with Nasopore group (n = 40), blood on the graft surface group (n = 40), or no EAC packing group (n = 40). All patients underwent endoscopic cartilage myringoplasty with middle ear packing. Self-reported subjective symptoms, graft success, audiometric outcomes, and complications were evaluated at up to 24 months postoperatively.
RESULTS: In total, 120 patients were randomized into the study groups. The rates of aural fullness were 79.49% in the EAC packing group, 28.95% in the blood on the graft surface group, and 21.05% in the no EAC packing group ( P < 0.001). At 24 months postoperatively, the graft success rates were 79.49% in the EAC packing group, 94.74% in the blood group, and 81.58% in the no EAC packing group, with a statistically significant difference among the groups ( P < 0.001). Pairwise comparisons demonstrated a significant difference between the EAC packing and blood on the graft surface groups ( P < 0.05), but no significant difference between the EAC packing and no EAC packing groups ( P > 0.05) or between the blood on the graft surface and no EAC packing groups ( P > 0.05). When outcomes were stratified by perforation size, the blood on the graft surface consistently demonstrated higher graft success rates compared with the EAC packing and no EAC packing groups for medium perforation. No significant differences were observed among the groups in terms of preoperative or postoperative mean air or bone conduction pure-tone averages, air-bone gaps, or air-bone gap closure. The incidences of myringitis were 5.13% in the EAC with Nasopore packing group, 7.89% in the blood on the graft surface group, and 28.95% in the no EAC packing group ( P < 0.001).
CONCLUSIONS: Autologous blood on the graft surface yielded higher graft success rates than EAC packing following cartilage underlay myringoplasty with middle ear packing, while there was no statistically significant difference between blood and no packing groups. Nevertheless, audiometric outcomes were comparable among these 3 arms.
MATERIALS AND METHODS: Patients with chronic perforation were randomly allocated to the EAC packing with Nasopore group (n = 40), blood on the graft surface group (n = 40), or no EAC packing group (n = 40). All patients underwent endoscopic cartilage myringoplasty with middle ear packing. Self-reported subjective symptoms, graft success, audiometric outcomes, and complications were evaluated at up to 24 months postoperatively.
RESULTS: In total, 120 patients were randomized into the study groups. The rates of aural fullness were 79.49% in the EAC packing group, 28.95% in the blood on the graft surface group, and 21.05% in the no EAC packing group ( P < 0.001). At 24 months postoperatively, the graft success rates were 79.49% in the EAC packing group, 94.74% in the blood group, and 81.58% in the no EAC packing group, with a statistically significant difference among the groups ( P < 0.001). Pairwise comparisons demonstrated a significant difference between the EAC packing and blood on the graft surface groups ( P < 0.05), but no significant difference between the EAC packing and no EAC packing groups ( P > 0.05) or between the blood on the graft surface and no EAC packing groups ( P > 0.05). When outcomes were stratified by perforation size, the blood on the graft surface consistently demonstrated higher graft success rates compared with the EAC packing and no EAC packing groups for medium perforation. No significant differences were observed among the groups in terms of preoperative or postoperative mean air or bone conduction pure-tone averages, air-bone gaps, or air-bone gap closure. The incidences of myringitis were 5.13% in the EAC with Nasopore packing group, 7.89% in the blood on the graft surface group, and 28.95% in the no EAC packing group ( P < 0.001).
CONCLUSIONS: Autologous blood on the graft surface yielded higher graft success rates than EAC packing following cartilage underlay myringoplasty with middle ear packing, while there was no statistically significant difference between blood and no packing groups. Nevertheless, audiometric outcomes were comparable among these 3 arms.