Myringoplasty: Impact of Size and Site of Perforation on the Success Rate

Myringoplasty aims to reconstruct the tympanic membrane, restoring protection to the middle ear and improve hearing. Success of Myringoplasty in terms of anatomical closure is influenced by many factors. This study focuses on the influence of size and site of tympanic membrane perforation on success rate of Myringoplasty. This is a prospective study of 60 patients who underwent myringoplasty and were then followed up for 6 months from the date of operation. Patients with dry perforation, with good cochlear reserve, intact and mobile ossicular chain, functioning Eustachian tube were selected randomly for the operation. Video Otoendoscopy of all cases with storz 0 degree endoscope were done. All images were recorded on the computer [DELL VOSTRO 3400]. Using ‘Image J’ [version 1.35j] geometrical package, the area of perforation (P) and the entire area of the tympanic membrane (T) were calculated. Then, the percentage area of the perforation [P/T × 100 %] for each ear was obtained. Site of perforation also documented. Success rate for pin-point and small perforations was 100 %, for medium size 80 %, and for large & subtotal perforations 69.2 and 42.9 % respectively. We regard size of the perforation as a major factor that influences success of Myringoplasty. Site of perforation failed to be a statistically significant influencing factor in this study.