WHY MYRINGOPLSTIES FAIL? IMPACT OF RELEVANT CLINICAL FACTORS ON THE SURGICAL OUTCOME; A STUDY FROM PAKISTAN

Authors

  • Saleem Asif Niazi Military Hospital Rawalpindi Cant
  • Shahid Farooq Khattak Combined Military Hospital Multan
  • Khoala KHan Atif Combined Military Hospital Tal, KPK
  • Atif Rafique Combined Military Hospital Multan
  • Mohammad Shahid Gohar Combined Military Hospital Rawalpindi

Abstract

Background: Myringoplasty is the reconstruction of the tympanic membrane by grafting. Success varies from 50–100%. A study was conducted to unveil the vital causes for failed myringoplasty with an aim to attenuate graft rejections and augment better outcomes. Methods: It was descriptive case series in which data was retrospectively collected at a tertiary care hospital (Rawalpindi, Pakistan) from January 2009 to December 2018. First 600 consecutive patients who qualified for inclusion/ exclusion criteria, underwent myringoplasties were followed-up for 06 months. Graft Take/Failure, the main outcome variable, was correlated with relevant independent variables. Data was collected on a structured pro forma, approved by hospital ethical committee. Data was analysed using IBM-SPSS-21.0. Results: Out of 600, 164 (27.3%) had graft rejection; failure being significantly enhanced by increasing age (p<0.001), larger perforation (p-0.025), co-morbidities (p<0.001), especially diabetics (p=0.040) and Eustachian tube (p-0.016) dysfunction amongst among systemic and ENT diseases respectively, and discharge-free ear (Dry Ear) for <4 weeks (p<0.001); while best graft take was achieved with end-aural surgical technique (p=0.048). Gender (p-0.897) did not caste a significant impact on graft outcome. Conclusion: The results of various surgical approaches of myringoplasty are equitable. Proper socio-demographic and clinical evaluation can improve graft outcome, and this surgery shall be discouraged in patients with diabetes mellitus and defective Eustachian Tube functions.

Author Biographies

Saleem Asif Niazi, Military Hospital Rawalpindi Cant

Associte Prof of ENT ENT Deaprtment

Shahid Farooq Khattak, Combined Military Hospital Multan

Asst Prof of ENT

Khoala KHan Atif, Combined Military Hospital Tal, KPK

Departmrnt of General Administration

Atif Rafique, Combined Military Hospital Multan

Asst Prof of ENT

Mohammad Shahid Gohar, Combined Military Hospital Rawalpindi

Asst Prof of ENT

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Published

2021-06-28