Size-based individualized tympanic membrane repair in elderly patients under otoendoscopy

Abstract

Objective: To explore the effectiveness and safety of different surgical methods based on perforation size selection for repairing tympanic membrane perforation (TMP) in elderly patients.

Methodology: This retrospective analysis included clinical data of 156 elderly patients who underwent TMP repair surgery at Tongren Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2022. Patients were grouped based on the size of TMP: the Group-S (TMP size ≤ 2mm, n=48) underwent TMP repair using the butterfly technique; The Group-M (2mm < TMP size ≤ 4mm, n=62) underwent TMP repair by tragus cartilage tympanoplasty; The Group-L (TMP > 4mm, n=46) underwent repair using the tragus cartilage-perichondrium membrane composite. The surgical time, intraoperative blood loss, healing rate, air bone gap (ABG), and complications among the three groups of patients were compared.

Results: The surgical time and intraoperative blood loss in the Group-S were significantly lower than those of the other two groups (P<0.05). After a six months follow-up, there was no statistically significant difference in the healing rate of the tympanic membrane among the three groups (P>0.05). The reduction in the ABG of the Group-S and the Group-M was greater than that of the Group-L (P<0.05). There was no statistically significant difference in the incidence of complications among the three groups (P>0.05).

Conclusions: For elderly patients with TMP, different surgical procedures can be selected according to the size of the perforation, and can achieve a high tympanic membrane healing rate and satisfactory hearing improvement effect.