FACTORS INFLUENCING THE SUCCESS RATE OF MYRINGOPLASTY

Objective: to know the factors influencing the success rate of myringoplasty. material and methods: this descriptive study was conducted at lady reading hospital peshawar, from june to december, 2004. fifty patients of central perforations in the tympanic membrane with dry ears for at least 6 months and no focus of infection in ear, nose, sinuses or throat were included in the study. twenty-five patients underwent underlay technique while in 25 patients onlay technique was carried out. results: graft was taken up successfully in 80% (40/50) cases. success rate was 84% in patients with underlay technique (21/25) and 76% in patients with onlay technique (19/25). the graft take up rate was 83.3% where temporalis fascia (30/36) was used and 71.4% where tragal perichondrium (10/14) was used as a graft material. the success rate was 100% in cases of traumatic perforation (6/6) and 77.3% in perforation caused by chronic suppurative otitis media{csom}(34/44); 87.5% in patients with medium sized perforation (14/16) and 83.3% in patients with large central perforation (20/24); 71.4% in patients with sclerotic mastoid (20/28) and 91% with cellular mastoid (20/22); 97.5% in patients with good eustachian tube function (39/40) and 10% in diseased eustachian tube (1/10). conclusion: the success rate of myringoplasty is affected by various factors especially age, nature and size of perforation, the type of graft used, cellularity of mastoid and good functioning eustachian tube. graft take up was better in cases of traumatic perforation than the perforation caused by csom.