Myringoplasty is one of the various surgical techniques for the management of chronic supurative otitis media.The present study is mainly focused to assess the extent of improvement of hearing post operatively in patients who underwent myringoplasty for CSOM. The study was conducted in patients with CSOM of tubo tympanic type who underwent myringoplasty in the Department of ENT, GITAM Institute of Medical Sciences and Research, Tertiary care Teaching Hospital, Visakhapatnam between February 2019 and September 2020. In this study the maximum number of patients were seen in the age group of 15-25 years (46%).In our study, the results were more encouraging in the younger age group with 11.7 dB in (15-25) age group,11.43 dB in (26-35) years age group and 11.8 dB in (36-45) years age group. While 4 myringoplasty were performed in patients aged over 45 years, the audiological benefit in speech frequency was found to be lesser at 8.74 dB.It has been established by this study that myringoplasty provides good results in terms of improvement of hearing post operatively. Myringoplasty has given immense relief to patients with CSOM, both in terms of discharge free ear and improvement of hearing. However, to ensure maximum success rate the operating surgeons should exercise caution to select patients only with conductive deafness and without any other ENT complications for successful myringoplasty. The study had concluded that, myringoplasty is a needful procedure to prevent recurrent infection of the middle ear and improves hearing. It is a simple, easy otologic surgery with good overall outcome.
Tony W. Anatomy and Development of the Ear and Hearing. Harold Ludman and Tony Wright’s Diseases of the Ear. 6th Edition. London: CRC Press;1998:3-31.
Jung Timthy TK, Hanson J. Classification of Otitis Media and Surgical Principles. Otolaryngol Clin N Am. 1999;32(3):369-80.
Saha Ashok K, Munsi DM. Evaluation of improvement in hearing in Type-1 Tympanoplasty and its influencing factors. Indian J Otolaryngol Head Neck Surg. 2005;58(3):253-7.
Athanasiadis-Sismanis A. Tympanoplasty: tympanic membrane repair. In: Gulya AJ, editor. Glasscock-Shambaugh, surgery of the ear, Chapter 28. 6. Philadelphia: W.B. Saunders Co.; 2012: 465.
Wullstein H. Theory and practice of tympanoplasty. Laryngoscope. 1956;66:1076–109.
Austin D.F., Shea J.J., Jr. A new system of tympanoplasty using vein graft. Laryngoscope. 1961;71:596–611.
Hough J.V. Tympanoplasty with interior fascial graft technique and ossicular reconstruction. Laryngoscope. 1970;80:1385–1401.
Michael M.D. Homograft tympanic membrane in myringoplasty. Ann. Oto. Rhino. Laryngol. 1972;81:194–202.
Sarker A.H., Ahmed Z., Patwary M., Islam P., Joarder R. Factors affecting surgical outcome of myringoplasty. Bangladish J. Otorhinolaryngol. 2011;17:82–87.
Ashfaq M, Aasim MU, Khan N. Myringoplasty: anatomical and functional results. Pak Armed Forces Med J. 2004;54(2):155–158.
Kageyama-Escobar AM, Rivera-Moreno MA, Rivera-Méndez A. Risk Factors Associated with Failure in Myringoplasty. Gac Med Mex. 2001;137(3):209-220.
Anirban Biswas’s. Clinical Audio-Vestibulometry for Otologists and Neurologists. 1st Edition. Pure Tone Audiometry. India; Bhalani Publications;2016:17.
Julianna Gulya A. Glasscock-Shambaugh’s Surgery of the ear. 6th Edition. Pathology and Clinical Course of the Inflammatory Disease of the Middle Ear. Europe; McGraw Hill: 2010:425-436.
Dawood MR. Hearing evaluation after successful myringoplasty. J Otol. 2017;12(4):192-197. doi:10.1016/j.joto.2017.08.005
Khafagy AG, Sobhy TS, Afifi PO. Do mastoidectomy and type of graft affect tympanoplasty outcome in Egyptian children? A prospective randomized study. Egypt J Otolaryngol. 2020; 36:7.
Agadurappa Mahadevaiah’s Surgical Techniques in Chronic Otitis Media and Otosclerosis. Tympanoplasty with/without Cortical Mastoidectomy. 2nd Edition. India: CBS Publishers & Distributors;2017:73-91.
Lee K, Schuknecht HF. Results of Tympanoplasty amd Mastoidectomy at Massachussets Eye and Ear Infirmary. Laryngoscope. 1971;81:529-543.
Wasson J.D., Papadimitriou C.E., Pau H. Myringoplasty: impact of perforation size on closure and audiological improvement. J. Laryngol. Otol. 2009;123:973–977.
Kumar T.V.V.V. Evaluation of various graft materials in myringoplasty. Int. J. Pharm. Bio. Sci. 2015;6:700–723.
Singh B.J., Sengupta A., Sudip D., Ghosh D., Basak B. A comparative study of different graft materials used in myringoplasty. Indian J. Otolaryngol. Head Neck Surg. 2009;61:131–134.
Yung MW, Myringoplasty: Hearing gain in relation to perforation site, Journal of Laryngology and Otology.1983 Jan,97(1):11-7
Karela M., Berry S., Watkins A., Phillippis J.J. Myringoplasty: surgical outcomes and hearing improvement: is it worth performing to improve hearing? Eur. Arch. Otorhinolaryngol. 2008;265:1039–1042.
Black J.H., Wormald P.J. Myringoplasty-effects on hearing and contributing factors. S. Afr. Med. J. 1995;85:41–43.
Blakley B.W., Kim S., Vancamp M. Preoperative hearing predicts postoperative hearing. J. Otolaryngol. Head Neck Surg. 1998;119:559–563.
Nagle SK, Jagade MV, Gandhi SR, Pawar PV. Comparative study of outcome of type I-tympanoplasty in dry and wet ear. Indian J Otolaryngol Head Neck Surg. 2009;61(2):138-140.
Asish J, Amar M, Vinay H, Sreekantha, Avinash SS, Amareshar M. To study the bacteriological and mycological profile of chronic suppurative otitis media patients and their antibiotic sensitivity pattern Int J Pharma Bio Sci. 2013; 4 186–199.
Bhat KV, Naseeruddin K, Nagalotimath US, Kumar PR, Hegde JS
Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: Is it routinely necessary? Laryngol Otol.2009;123(4): 383-90.
Agarwal D, Sandeep V, Sunil K. Tympanoplasty with and without cortical mastoidectomy in treatment of inactive mucosal chronic otitis media. International Journal of Otorhinolaryngology and Head and Neck Surgery. Jul-Aug2019;5(4):1-8.
Khafagy AG, Sobhy TS, Afifi PO. Do mastoidectomy and type of graft affect tympanoplasty outcome in Egyptian children? A prospective randomized study. Egypt J Otolaryngol. 2020; 36(7):1-5.