Comparison of permeatal medial placement of graft without raising the tympano-meatal flaps to conventional methods of myringoplasty: An experience at tertiary care hospital in pakistan

Objective: to compare the results of permeatal approach without raising the tympano-meatal flap to endaural or post-aural approach in myringoplasty. methods: this quasi-experimental study was carried out in cmh (combined military hospital) peshawar,from august 2006 to july 2013. three hundred fifty patients of chronic suppurative otitis media (csom) with dry central; small,medium and large perforations were selected. they were divided into two groups depending upon the type of approach. in group-a (n-200); permeatal approach without raising tympanomeatal flap was used; while in group-b (n-150) end-aural or post-aural approach was used. subjects were followed up for two years; graft take was checked regularly by examinations of ear under microscope. data was collected on structured performa and analysed by spss-17. results: male and female were 74% and 26% respectively; age ranged from 15 to 46 years. there was no significant difference in the graft success at the end of two years in group-a (80%) and group-b (85%) (p-0.261). type of approach had a significant impact on duration of surgery (p<0.001) and post-operative recovery time (p<0.001). conclusion: the permeatal approach and end-aural/post-aural approach had almost equal graft success rates,but former is more useful as it causes lesser morbidity,decreased post-operative hospital stay and reduced operative time. it is under-utilized and should be employed more frequently. © 2016,pakistan journal of medical sciences. all rights reserved.