CzMA JEP Home page CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ
Journals - Article
CzMA JEP Home page News About Assocation Publishing Division Medical Journals Searching Supplements Catalogue
 
  Česky / Czech version Otorinolaryng. a Foniat. /Prague/, 50, 2001, No. 1, pp. 21 - 25.
 
Retromyringal Myringoplasty 
Schaffer M., Hroboň M., Rambousek P., Skřivan J., Světlík M. 

Klinika otorinolaryngologie a chirurgie hlavy a krku 1. LF UK a FN Motol, Praha,
 


Summary:

       The submitted retrospective study evaluates the results of myringoplasties made at the Clinic for ENT and Head and Neck Surgery of the Motol Faculty Hospital, First Medical Clinic Charles University, Chair of the Institute of Postgraduate Medical Training in 1996 - 1997. A group of 147 patients in involved - 101 primary operations and 46 revisions. As to revisions the first revision was made 26 times (57% of the total number of revisions, incl. 11 revisions of operations made in another department (42%). A 2nd revision was made 13 times (28% of the total number of revisions) incl. 6 times revision of operations performed in another department (46%). A 3rd revision was made 7 times (15% of the total number of revisions), incl. 3 of operations made elsewhere (43%). In all instances the underlay technique was used with a tympanomeatal flap. As graft a temporal fascia was used, perichondrium and chondroperichondrium which was taken mostly from the tragus. The mean follow up period was 8.3 months. The success rate of primary operations was 77%. The fascia was used in 96%, perichondrium and chondroperichondrium in 2% each. During the 1st revision a fascial graft was used in 62% with a success rate of 75%, perichondrium and chondroperichondri- um in 35% and in one instance a chondrofascial graft was used (4%) with a success rate of 60%. During the 2nd and 3rd revision a fascial graft was used in 50% with a success rate of 60%. Condroperochon- drium and perichondrium were used in 50% with a success rate of 80%. In unsuccessful myringoplasties more frequent dehiscence in the anterior lower quadrant was found. In subtotal perforations there was a lower rate of successful healing (64 %) similarly as in perforations which developed as a result of scaling. In one instance despite incorporation of the graft hearing deteriorated and ten times it did not improve (incl. 7 cases where a non-fascial graft was used). In one instance marked dysaesthesia in the area of the auditory meatus was observed and in one instance marked tinnitus. In conjunction with successful healing of myringoplasties various prognostic factors are mentioned. The most frequently quoted ones are the pathogenesis of development of the perforation, the size of the perforation, site of the perforation, type of graft used, patient’s age, experience of the surgeon, number of previous operations, previous adenotomies in children and immunological state of the patient. The influence of these factors is discussed.

        Key words: myringoplasty, perforation of the tympanic membrane, retromyringal technique, fascial graft, perichondral graft, chondroperichondral graft, revision myringoplasty.
       

Order this issue

  BACK TO CONTENTS  
 
 
| HOME PAGE | CODE PAGE | CZECH VERSION |
©  1998 - 2008 CZECH MEDICAL ASSOCIATION J. E. PURKYNĚ
Created by: NT Servis, s.r.o., hosted by P.E.S. consulting, s.r.o.
WEBMASTER