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ASSESSMENT OF HEARING OUTCOMES AFTER MYRINGOPLASTY IN
PATIENTS WITH CHRONIC SUPPURATIVE OTITIS MEDIA
¹Xoʻjamurodov Shoxruhbek Oromjonovich
²Nu'monov Asadbek Ikrom o'g'li
³G'ulomov Adham Majid oʻgʻli
¹'²'³Samarkand State Medical University, Department of Otorhinolaryngology No. 2, 1st Year
Clinical Residents.
https://doi.org/10.5281/zenodo.15511385
Research Objective
The primary objective of this study was to evaluate the functional outcomes of
myringoplasty in terms of hearing improvement and graft uptake in patients diagnosed with
chronic suppurative otitis media (CSOM) with tympanic membrane perforation.
Materials and Methods
This prospective study was conducted over a period of 8 months at the ENT Department
No. 2, Samarkand State Medical University.
Study Population:
A total of 36 patients aged 18 to 55 years with inactive mucosal type CSOM and central
tympanic membrane perforation were selected.
Inclusion Criteria:
- Diagnosed CSOM (mucosal type) with dry ear for at least 6 weeks
- Pure tone audiometry (PTA) confirming conductive hearing loss
- Normal middle ear mucosa
Exclusion Criteria:
- Mixed or sensorineural hearing loss
- Ossicular chain erosion
- Recurrent perforation or revision surgery
- Active infection at the time of surgery
Preoperative Assessment:
- Otoscopic examination
- Audiological evaluation with PTA
- High-resolution CT scan of the temporal bone (when necessary)
Surgical Technique:
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All patients underwent myringoplasty using the underlay technique with temporalis
fascia graft under general anesthesia. The procedure was performed by experienced ENT
surgeons under microscope guidance.
Follow-up and Outcome Measures:
Follow-up visits were scheduled at 2 weeks, 1 month, and 3 months post-surgery. The
outcomes assessed included:
- Graft uptake (closure of perforation)
- Hearing gain (improvement in air conduction thresholds in dB)
- Postoperative complications
Results
Out of 36 patients:
- Graft success rate: 91.7% (33 out of 36 patients achieved complete closure of the
perforation)
- Hearing improvement:
- Average hearing gain: 18.2 dB
- 83.3% of patients showed ≥15 dB improvement in air conduction
Complications
:
- 2 patients had graft rejection
- 1 patient had otorrhea in the postoperative period, resolved with conservative treatment
- No major complications like sensorineural hearing loss or facial nerve injury
Discussion
Chronic suppurative otitis media remains a significant cause of preventable hearing loss,
especially in developing countries. Myringoplasty is a simple and effective procedure aimed at
restoring the integrity of the tympanic membrane and improving hearing.
The success of the surgery depends on multiple factors including proper case selection,
surgical technique, size and site of perforation, and the condition of the middle ear mucosa.
Our study showed that with adequate preoperative assessment and standard surgical
technique, the majority of patients achieved satisfactory hearing improvement and graft uptake.
The use of temporalis fascia remains a reliable graft material.
While complications were minimal, strict postoperative care and patient compliance
were essential to prevent failures.
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Conclusion
Myringoplasty is a highly successful procedure for repairing tympanic membrane
perforations in CSOM. It leads to significant hearing improvement with minimal complications.
Early diagnosis, appropriate timing of surgery, and meticulous surgical execution are
key to optimizing outcomes.
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