Comparison of Myringitis Incidence in Cartilage Myringoplasty With and Without External Ear Canal Packing For the Repair of Chronic Tympanic Membrane Perforations.

Objective

We compared the long-term efficacy and incidence of myringitis after cartilage graft underlay myringoplasty for chronic tympanic membrane (TM) perforations with and without external ear canal (EAC) packing.

Methods

In total, 129 patients who met the inclusion criteria were allocated to either the EAC packing (packing) group or the no-EAC packing (no-packing) group. All patients underwent endoscopic cartilage graft underlay myringoplasty. Graft success, hearing improvement, and the incidence of myringitis were assessed at 12 months postoperatively.

Results

All patients completed the 12 month follow-up period. At 3 months postoperatively, overall graft success rates were 100.0% and 98.4% in the packing and no-packing groups, respectively. At 12 months postoperatively, graft success rates were 96.9% and 93.8% in the packing and no-packing groups, respectively. Both groups demonstrated significant improvements in hearing between preoperative and 6 month postoperative assessments. The mean air-bone gap (ABG) improved by 14.17 ± 3.29 decibels (dB) in the packing group and 13.85 ± 5.46 dB in the no-packing group. At 6th month postoperatively, no significant differences in ABGs were observed between the groups. The incidence of myringitis was significantly higher in the no-packing group than in the packing group. However, the packing group exhibited a significantly-higher incidence of self-reported ear fullness and discomfort than the no-packing group.

Conclusion

Although the graft success rate and hearing improvement after cartilage graft underlay myringoplasty with no EAC packing were comparable to those with packing, the no-packing approach was associated with a higher incidence of myringitis. Therefore, we recommend EAC packing after cartilage myringoplasty.