A novel way of cutting Silastic®sheeting

Factors affecting the treatment outcomes of myringoplasty in patients with small tympanic membrane perforations

PURPOSE

Factors affecting the outcomes of myringoplasty have been widely discussed but remain controversial. In this study, we retrospectively analyzed the factors associated with the outcomes of myringoplasty treating small tympanic membrane perforations (defined as those involving less than 30% of the whole eardrum area) in patients with a history of chronic otitis media.

METHODS

The clinical demographic data, preoperative pure tone audiometry, surgical procedures, and surgical outcomes of patients with small tympanic perforations were analyzed statistically. Overlay myringoplasty was performed in 24 ears (45.27%); Gelfoam^® plugs were placed in 29 ears (54.73%). Univariate and multivariate tests among demographic, surgical procedure-related, hearing test-related factors were performed.

RESULTS

A total of 53 patients (22 males and 31 females) were enrolled (mean age 54.84 ± 15.51 years). Fourteen patients (26.41%) had the habit of cigarette smoking, 8 (15.09%) had diabetes mellitus, 20 (37.73%) had a past history of chronic otitis media, 5 (9.43%) had a history of grommet insertion, 5 (9.43%) had received radiotherapy in the head and neck region, and 1 (1.88%) had microtia. The success rate for overlay myringoplasty using Silastic^® sheets was 54.16%; the success rate for Gelfoam^® plugs was 54.16%. On univariate analysis, smoking, older age, and the mean air conduction and bone conduction hearing levels significantly affected the surgical outcomes. Cigarette smoking was the only independent (negative) prognostic factor of surgical success on multivariate analysis (OR  = 0.1614, 95% CI: 0.0336-0.7762, p = 0.0228).

CONCLUSION

As for surgical repair for the small tympanic membrane perforations with a history of chronic otitis media, age, cigarette smoking, mean air conduction threshold, and mean bone conduction threshold were associated with surgical outcomes; cigarette smoking was the independent predictive prognostic factor for the surgical outcomes.

Insertion of middle-ear Silastic sheeting during tympanoplasty: hearing outcomes

Objective:

To study the effect of Silastic®sheeting placed in the middle ear during tympanoplasty, including the effect on hearing.

Design:

Retrospective study.

Background:

Chronic inflammation of the middle ear is common. Surgical treatment sometimes results in middle-ear adhesions and hearing deterioration.

Materials and methods:

We selected 106 patients with chronic otitis media, middle-ear adhesions and intact ossicles, based on intra-operative findings. These patients underwent single-stage tympanoplasty either with or without insertion of Silastic sheeting. Audiometry was undertaken pre-operatively and one and 12 months post-operatively.

Results:

Patients who had undergone Silastic sheet insertion showed significantly better air conduction, bone conduction and air–bone gap averages one year post-operatively, compared with those who had not.