Hostname: page-component-669899f699-tzmfd Total loading time: 0 Render date: 2025-04-25T00:57:43.776Z Has data issue: false hasContentIssue false
  • English
  • Français

Raising a mucosal flap vs. tympanomeatal flap to repair subtotal perforations

Published online by Cambridge University Press:  21 October 2024

Yajian Shen  and
Zhengcai Lou Open the ORCID record for Zhengcai Lou [Opens in a new window]
Yajian Shen
Affiliation:
Department of Otorhinolaryngology,Yiwu Central Hospital, Yiwu City, Zhejiang Province, China
Zhengcai Lou*
Affiliation:
Department of Otorhinolaryngology,Yiwu Central Hospital, Yiwu City, Zhejiang Province, China
*
Corresponding author: Zhengcai Lou; Email: [email protected]; Fax number: +86-057985209678;
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

This study aimed to compare the graft success rate, hearing outcomes, operation time and complications between myringoplasty with raising of a mucosal flap (RMF) and raising of a tympanomeatal flap (RTF) for the repair of subtotal perforations.

Methods

Subtotal perforations were recruited and randomly allocated to either the RMF group or the RTF group. The graft success rate, hearing outcomes and complications were evaluated at 6 months post-operatively.

Results

The mean operation time was 31.4 ± 2.8 minutes (range: 26–47) in the RMF group and 57.6 ± 0.9 minutes in the RTF group (p < 0.01). The graft success rate was 96.0 per cent in the RMF group and 88.9 per cent in the RTF group (p = 0.659).

Conclusion

Endoscopic myringoplasty with the RMF achieved similar graft success and hearing gain compared to the tympanomeatal flap technique for repairing subtotal perforations, but with significantly shorter operation time and minimal temporary hypogeusia.

Keywords

complicationseardrumendoscopemyringoplasty
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 2 , February 2025 , pp. 107 - 112
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Zhengcai Lou takes responsibility for the integrity of the content of the paper

References

Schwam, ZG, Cosetti, MK. Endoscopic myringoplasty and type I tympanoplasty. Otolaryngol Clin North Am 2021;54:75–88Google ScholarPubMed
Nicholas Jungbauer, W Jr, Jeong, S, Nguyen, SA, Lambert, PR. Comparing myringoplasty to type I tympanoplasty in tympanic membrane repair: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2023;168:922–34CrossRefGoogle ScholarPubMed
Huang, Y-B, Hu, L-L, Ren, D-D, Han, Z. Myringoplasty with an ultrathin cartilage-perichondrium complex graft versus temporalis fascia graft: a propensity score-matched analysis. Otolaryngol Head Neck Surg 2021;164:1287–93CrossRefGoogle Scholar
Iynen, I, Dundar, R. Chorda Tympani nerve injury during tympanoplasty. Comparison of endoscopic and microscopic methods. Ann Ital Chir 2021;92:119–22Google ScholarPubMed
Quancheng, L, Jiangtao, Z, Liang, C. Variation and protection of the chorda tympani nerve in endoscopic ear surgery. Laryngoscope Investig Otolaryngol 2022;7:1107–12CrossRefGoogle ScholarPubMed
Berglund, M, Suneson, P, Florentzson, R, Fransson, M, Hultcrantz, M, Westman, E, et al. Tinnitus and taste disturbances reported after myringoplasty: data from a national quality registry. Laryngoscope 2019;129:209–15CrossRefGoogle ScholarPubMed
Gülşen, S, Arıcı, M. Reply to the letter to the editor concerning ‘The elevation of the mucosal flap without additional anterior canal wall incisions for repairing anterior perforations using endoscopic cartilage tympanoplasty.’ Eur Arch Otorhinolaryngol 2020;277:1853–4CrossRefGoogle Scholar
Shoman, NM. Clinical and audiometric outcomes of palisade cartilage myringoplasty under local anesthetic in an office setting. Am J Otolaryngol 2019;40:482–6CrossRefGoogle Scholar
Lou, Z. Endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap for repairing anterior tympanic membrane perforations. Ann Otol Rhinol Laryngol 2020;129:795–800Google ScholarPubMed
Gülşen, S, Arıcı, M. Endoscopic transcanal versus conventional microscopic tympanoplasty in treatment of anterior tympanic membrane perforations. Eur Arch Otorhinolaryngol 2019;276:3327–33CrossRefGoogle ScholarPubMed
Lou, Z, Lou, Z, Jin, K, Sun, J, Chen, Z. Excising or preserving perforation margins in endoscopic transtympanic cartilage myringoplasty does not affect surgical success. Clin Otolaryngol 2022;47:94–9CrossRefGoogle Scholar
Lou, Z, Lou, Z, Lv, T, Chen, Z. Comparison of endoscopic modified and typical myringoplasty: A randomized controlled trial. Laryngoscope 2023;133:2779–85CrossRefGoogle ScholarPubMed
Borgstein, J, de Zwart, G, Bruce, IA. Ear packing after ear surgery: Is it really necessary? J Laryngol Otol 2008;122:253–4CrossRefGoogle ScholarPubMed
Nakhla, V, Takwoingi, YM, Sinha, A. Myringoplasty: A comparison of bismuth iodoform paraffin paste gauze pack and tri-adcortyl ointment ear dressing. J Laryngol Otol 2007;121:329–32CrossRefGoogle ScholarPubMed
Lou, Z, Lou, Z, Chen, Z. Effect of packing versus no packing in transperforation myringoplasty for chronic tympanic membrane perforations. Otolaryngol Head Neck Surg 2023;169:1170–8CrossRefGoogle ScholarPubMed
Lou, Z, Lou, Z, Yu, D, Wang, J, Lv, T, Chen, Z. Comparison of endoscopic over-underlay technique with and without packing for repairing chronic perforation. Eur Arch Otorhinolaryngol 2022;279:4761–8CrossRefGoogle ScholarPubMed
Wuesthoff, C, Hardman, J, Saxby, AJ, Jufas, N, Patel, N. How I do it: endoscopic composite cartilage graft tympanoplasty. Aust J Otolaryngol 2018;1:33CrossRefGoogle Scholar
Vamanshankar, H, Mokshagundam, R. Endoscopic tragal cartilage graft for tympanoplasty: a case series. Jpn J Otolaryngol 2020;1:102Google Scholar
Angeli, SI, Kulak, JL, Guzmán, J. Lateral tympanoplasty for total or near-total perforation: prognostic factors. Laryngoscope 2006;116:1594–9CrossRefGoogle ScholarPubMed
Cohen-Vaizer, M, Barzilai, R, Shinnawi, S. Inlay triple- “C” tympanoplasty: a comparative study for its use in large, marginal perforations. Eur Arch Otorhinolaryngol 2021;278:3715–22Google ScholarPubMed
Casas A, Linares, Ruiz, R, De Pauli, D. Endoscopic type 1 tympanoplasty: a composite graft technique for subtotal and total perforations. Eur Arch Otorhinolaryngol 2022;279:181–6CrossRefGoogle Scholar
Dhungana, S, Rayamajhi, P, Shrivastav, RP. Outcome of graft uptake and hearing results between ‘U’ flap technique and conventional tympanomeatal flap technique for anterior and subtotal tympanic membrane perforation. J Nepal Health Res Counc 2018;16:297–301CrossRefGoogle ScholarPubMed
Faramarzi, M, Atashi, S, Edalatkhah, M, Roosta, S. The effect of anterior tab flap technique on graft success rate in large tympanic membrane perforation. Eur Arch Otorhinolaryngol 2021;278:1765–72CrossRefGoogle ScholarPubMed
Govaerts, PJ, Raemaekers, J, Verlinden, A, Kalai, M, Somers, T, Offeciers, FE. Use of antibiotic prophylaxis in ear surgery. Laryngoscope 1998;108:107–10CrossRefGoogle ScholarPubMed
Cheng, H, Chen, BP, Soleas, IM, Ferko, NC, Cameron, CG, Hinoul, P. Prolonged operative duration increases risk of surgical site infections: A systematic review. Surg Infect (Larchmt) 2017;18:722–35Google ScholarPubMed
Jackson, CG. Antimicrobial prophylaxis in ear surgery. Laryngoscope 1988;98:1116–23CrossRefGoogle ScholarPubMed
Ziylan, F, Smeeing, DPJ, Bezdjian, A, Stegeman, I, Thomeer, HGXM. Feasibility of preservation of chorda tympani nerve during noninflammatory ear surgery: a systematic review. Laryngoscope 2018;128:1904–13CrossRefGoogle ScholarPubMed
Takahashi, M, Motegi, M, Yamamoto, K, Yamamoto, Y, Kojima, H. The pre-chorda and post-chorda tympani approach in endoscopic stapes surgery based on the chorda tympani nerve classification. Eur Arch Otorhinolaryngol 2022;279:5945–49CrossRefGoogle ScholarPubMed