Vascularisation of myringo-/tympanoplastic grafts in active and inactive chronic mucosal otitis media: a prospective cohort study.

OBJECTIVES

To evaluate the vascularisation process of the grafted fascia or perichondrium in active and inactive chronic mucosal otitis media.

DESIGN

Prospective study.

SETTING

University-based, secondary referral hospital.

PARTICIPANTS

Two hundred thirty-two patients who underwent type 1 tympanoplasty or myringoplasty by one experienced surgeon.

MAIN OUTCOME MEASURES: After postoperative days 5-7, the graft was inspected using a binocular operating microscope at least twice weekly until vascularisation was confirmed to have commenced. This point was defined as the time of vascularisation. An intact graft at 3 months postoperatively was considered a closure success.

RESULTS

The mean time of vascularisation of 232 grafts was 14.2 ± 3.6 days (range 8-25). The vascularisation time differed according to the perforation size. The perforations involving 50% and less of the pars tensa were revascularised earlier than those involving 75% and more. There was no relationship between vascularisation time and closure success or failure. Age itself did not influence the vascularisation time or the risk of closure failure. Postoperative otorrhea was higher in patients with a preoperative wet middle ear mucosa than among those with a dry one.

CONCLUSION

The vascularisation time was shorter in perforations of 50% and less than those of 75% and more but the rate of closure success was not different between two. The graft failure was not attributed to the failure of vascularisation. Age itself seemed not to be a contraindication for myringo-/tympanoplasty in otherwise healthy elderly patients.