Comparison of Myringitis Incidence in Cartilage Myringoplasty With and Without External Ear Canal Packing For the Repair of Chronic Tympanic Membrane Perforations

Objective: We compared the long-term efficacy and incidence of myringitis after cartilage graft underlay myringoplasty for chronic tympanic membrane (TM) perforations with and without external ear canal (EAC) packing. Methods : In total, 129 patients who met the inclusion criteria were allocated to either the EAC packing (packing) group or the no-EAC packing (no-packing) group. All patients underwent endoscopic cartilage graft underlay myringoplasty. Graft success, hearing improvement, and the incidence of myringitis were assessed at 12 months postoperatively. Results: All patients completed the 12 month follow-up period. At 3 months postoperatively, overall graft success rates were 100.0% and 98.4% in the packing and no-packing groups, respectively. At 12 months postoperatively, graft success rates were 96.9% and 93.8% in the packing and no-packing groups, respectively. Both groups demonstrated significant improvements in hearing between preoperative and 6 month postoperative assessments. The mean air-bone gap (ABG) improved by 14.17 ± 3.29 decibels (dB) in the packing group and 13.85 ± 5.46 dB in the no-packing group. At 6th month postoperatively, no significant differences in ABGs were observed between the groups. The incidence of myringitis was significantly higher in the no-packing group than in the packing group. However, the packing group exhibited a significantly-higher incidence of self-reported ear fullness and discomfort than the no-packing group. Conclusion: Although the graft success rate and hearing improvement after cartilage graft underlay myringoplasty with no EAC packing were comparable to those with packing, the no-packing approach was associated with a higher incidence of myringitis. Therefore, we recommend EAC packing after cartilage myringoplasty.