ENT - September 2020 - 524

524

Ear, Nose & Throat Journal 99(8)
Table 1. Characteristics of patients and perforations in groups.
Group 1: Unilateral Group 2: Bilateral
Cases (40 Patients)a Cases (22 Patients)
Age (years)
Gender (female/male)
Side operated (left/
right)
Location of perforation
Anterior
Posterior
Inferior
Type of perforation
Central
Marginal

36.7 (12.6)
18/22
21/19

38.1 (13.5)
13/9
28/16

26 (65.0%).
8 (20.0%)
6 (15.0%)

27 (61.4%)
12 (27.3%)
5 (11.3%)

36 (90.0%)
4 (10.0%)

39 (88.7%)
5 (11.3%)

P
.633
.197
.208

.697

.840

a

Significance level: P < .05.

Figure 3. Photograph showing 2 pieces of cartilage grafts obtained
from tragal cartilage.

clavulanate), analgesics, and cetirizine for 7 days postoperatively. Stitches and aural dressings were typically removed
1 week postoperatively, and AGS fragments were aspirated,
thereby permitting visualization of the graft. Ear drops containing topical antibiotics (ofloxacin) were administered for
1 week postoperatively to prevent local infections twice daily
for 2 to 4 weeks.
Pre- and postoperative air and bone conduction thresholds
were measured at 500, 1000, 2000, and 3000 Hz using a clinical
audiometer (Interacoustic AC-40, Assens, Denmark). A repeat
audiogram was performed at the end of the sixth month. Air-
bone gaps were calculated as the average difference between
air and bone conductions at 4 frequencies (0.5, 1, 2, and 3 kHz).
A successful functional result was defined as a postoperative
ABG of 10 dB.
Postoperative follow-up controls were conducted at the hospital at the first, second, and third weeks; first, third, sixth, and
12th months; and annually thereafter. Anatomical success was
defined as full, intact healing of the without perforation, retraction, or lateralization evaluated by microscopy at the last followup visit at 12 months. The operation time was recorded as the time
taken from tragal local anesthesia to the closure of the incision
after placement of the graft using the underlay technique.
Statistical analyses were performed using SPSS version 20
(SPSS Inc, IBM Company, Chicago, Illinois). The data were
expressed as mean (standard deviation [SD]) and percentage
(%). The w2 test was used for the comparison of groups and
recovery rates. Normality of data was examined with the
Kolmogorov-Smirnov test. The Wilcoxon and Mann-Whitney
U tests were used for nonparametric variables, while independent
and paired samples t tests were employed for parametric variables. A P value of <.05 was accepted as statistically significant.

Table 2. Comparison of anatomical success between groups.
Group 1
Graft success

37/40 (92.5%)

Group 2
41/44 (93.2%)

Pa
.904

a

Significance level: P < .05.

criteria were evaluated. The mean follow-up period was
21.2 + 7.2 months (range, 12-36 months). Patient characteristics are given in Table 1. There were no statistically significant
differences between the 2 groups in terms of age (36.7 [12.6]
and 38.4 [14.1] years, respectively; P ¼ .618), gender, operated
side, and type and location of TM perforation.
The graft success rates were 92.9% (78 ears), 92.5% (37
ears), and 93.2% (41 ears) for overall, group 1, and group 2,
respectively (not statistically significant, P ¼ .904; Table 2).
Additionally, the mean preoperative ABGs of groups 1 and 2
were 20.5 (6.9) dB, 21.1 (7.1) dB, and 20.5 (6.7) dB, respectively, whereas the mean postoperative ABGs were 10.9 (9.7)
dB, 8.1 (2.7) dB, and 7.9 (3.0) dB, respectively. The difference
between the pre- and postoperative ABGs for the entire group
was statistically significant (P < .001). The functional success
rate (ABG 10 dB) for the entire group was 82.1% (69 ears).
The functional success rates were similar in both groups
(P ¼ .582; Table 3). The mean hearing gain was 12.5 (11.0)
dB and 15.6 (10.1) dB in groups 1 and 2, respectively, and the
postoperative ABG was 10 dB in 33 (82.5%) and 36 (81.8%)
ears in groups 1 and 2, respectively. There were no statistically
significant differences between the groups in terms of hearing
gain (P ¼ .183). Lastly, the average lengths of operation time
were 61.6 (12.5) minutes and 110.1 (25.2) minutes for groups 1
and 2, respectively.

Discussion
Results
A total of 62 patients (mean age, 37.3 [13.1] years) with 84
operated ears (35 left, 49 right) who met the aforementioned

We documented the practicality of bilateral same-day myringoplasty in bilateral TM perforations caused by COM. The
underlay technique was used to treat ears through a transcanal
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