ORIGINAL ARTICLES   

Otorinolaringologia 1999 March;49(1):11-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Transmeatal underlay myringoplasty. Indications and results

Albera R., Riontino E., Milano F., Lacilla M., Gervasio C. F., Cavalot A. L., Giordano L., Bussi M., Ferrero V.

Università degli Studi - Torino Dipartimento di Fisiopatologia Clinica II Cattedra di ORL

Background. Underlay myringoplasty is a surgical technique of tympanic reconstruction consisting in the positioning of the graft under the tympanic remnants. Aim of the study is to evaluate the indications and results of transmeatal underlay myringoplasty (TUM) with autologus or homologous dehydrated temporalis fascia.
Methods. The study population was composed of 88 subjects, all affected by posterior tympanic perforation that could be completely visible by the transmeatal approach. Patients were submitted to TUM with autologus temporalis fascia in 23 cases and homologous dehydrated temporalis fascia in 65 cases. In 16 cases the operation was conducted in general anesthesia while in all the other cases the local anesthesia was adopted.
Results. In 81% of the cases the closure of tympanic perforation was obtained with a healing time raging from 10 to 35 days. Among the different parameters evaluated only age had a correlation with outcome since younger subjects had better results. After surgery the average air-bone gap at 05-1-2-3 KHz improved from 16 to 8 dB and in 76% of patients the air-bone gap closed to within 10 dB.
Conclusions. TUM can be considered a quick and easy technique allowing to achieve tympanic membrane closure in a high rate of cases, only a little lower than most aggressive techniques. This low-risk and well-accepted procedure appears to be indicated as the first approach in the treatment of tympanic membrane perforations that can be completely seen at otomicroscopic inspection.