Comparison of cartilage myringoplasty for repairing non-cholesteatomatous chronic perforation with mastoid cavity pneumatization and opacification

Abstract

Objective

The objective of this study was to compare the graft outcomes of cartilage myringoplasty for the repair of chronic otitis media (COM) with a complete ossicular chain between mastoid cavity pneumatization and opacification.

Materials and methods

Chronic perforations with non-cholesteatomatous COM were allocated to either mastoid cavity pneumatization (MCP) group and opacification (MCO) group. All patients underwent endoscopic cartilage underlay myringoplasty alone. The graft success rate, audiometric outcomes, soft tissue opacification change, and complications were evaluated at 12 months after surgery.

Results

The postoperative infection was 2.7 % patients in the MCP group and 8.1 % patients in the MCO group (P = 0.607). Overall graft success rates were 91.9 % in the MCP group and 89.2 % in the MCO group (P = 0.691). MCO group exhibited more deterioration in preoperative air conduction (AC) PTAs (P = 0.047) or pre-operative ABG (P = 0.039) compared with MCP group, while there were no significant differences between the groups in postoperative AC PTAs, BC PTAs, or ABGs. Nevertheless, MCO group exhibited better ABG gain compared with MCP group (21.2 ± 6.9 vs 13.8 ± 2.6 dB; P = 0.024). Temporal bone CT at postoperative 12 months revealed no change in opacification in 56.8 % patients and reduced opacification or complete pneumatization in 43.2 % patients in the CMO group. Also, none of the patients developed worsening sensorineural hearing loss or postoperative tinnitus.

Conclusions

Myringoplasty alone did not affect the graft success rate in the patients with mastoid cavity pneumatization or opacification, however, in comparison, the patients with mastoid cavity opacification had a worse preoperative hearing but better postoperative hearing recovery. In addition, myringoplasty alone could improve the mastoid cavity opacification.