Abstract
We evaluated the postoperative audiological findings and perforation closure rate of in 164 ears of patients with perforated otitis media following tympanoplasty conducted via a retroauricular approach (underlay technique for myringoplasty) by the same operator. The results demonstrated a success rate of improved hearing of 90.2% and a tympanic membrane closure rate at more than one year after the surgery of as high as 92.1%. To assess the factors affecting the postoperative hearing improvement, logistic regression analysis was carried out. Ossicular reconstruction (Type III) and presence of tympanosclerosis were identified as statistically significant negative factors unfavorably affecting postoperative hearing improvement. The tympanic membrane perforation closure rate was higher in younger patients. There were no significant differences of the tympanic membrane perforation closure rate depending on the size of the perforation or the underlying disease.
No correlation was observed between the operative experience and the audiological outcomes or perforation closure rate, suggesting that this operation may be relatively easy to master. Since the tympanic membrane closure rate was higher than that achieved by the adhesive technique and was comparable to that obtained using the overlay technique, it was considered that the underlay technique via a retroauricular approach may be an excellent choice for the first operation, because it causes less postoperative lateralization of the repaired tympanic membrane.
