European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 11, pp 3005–3012 | Cite as

Factors affecting the treatment outcomes of myringoplasty in patients with small tympanic membrane perforations

  • Shih-Lung Chen
  • Shih-Wei YangEmail author



Factors affecting the outcomes of myringoplasty have been widely discussed but remain controversial. In this study, we retrospectively analyzed the factors associated with the outcomes of myringoplasty treating small tympanic membrane perforations (defined as those involving less than 30% of the whole eardrum area) in patients with a history of chronic otitis media.


The clinical demographic data, preoperative pure tone audiometry, surgical procedures, and surgical outcomes of patients with small tympanic perforations were analyzed statistically. Overlay myringoplasty was performed in 24 ears (45.27%); Gelfoam® plugs were placed in 29 ears (54.73%). Univariate and multivariate tests among demographic, surgical procedure-related, hearing test-related factors were performed.


A total of 53 patients (22 males and 31 females) were enrolled (mean age 54.84 ± 15.51 years). Fourteen patients (26.41%) had the habit of cigarette smoking, 8 (15.09%) had diabetes mellitus, 20 (37.73%) had a past history of chronic otitis media, 5 (9.43%) had a history of grommet insertion, 5 (9.43%) had received radiotherapy in the head and neck region, and 1 (1.88%) had microtia. The success rate for overlay myringoplasty using Silastic® sheets was 54.16%; the success rate for Gelfoam® plugs was 54.16%. On univariate analysis, smoking, older age, and the mean air conduction and bone conduction hearing levels significantly affected the surgical outcomes. Cigarette smoking was the only independent (negative) prognostic factor of surgical success on multivariate analysis (OR  = 0.1614, 95% CI: 0.0336–0.7762, p = 0.0228).


As for surgical repair for the small tympanic membrane perforations with a history of chronic otitis media, age, cigarette smoking, mean air conduction threshold, and mean bone conduction threshold were associated with surgical outcomes; cigarette smoking was the independent predictive prognostic factor for the surgical outcomes.


Prognostic factor Silastic® sheet Gelfoam® plug Myringoplasty Tympanic membrane perforations Chronic otitis media 



Chronic otitis media


Pure tone audiometry


Diabetes mellitus


Air conduction


Bone conduction


Air–bone gap



The authors thank all the members of Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, for their invaluable help.

Author Contributions

Resources: S-LC, S-WY. Supervision: S-WY. Writing—original draft: S-LC. Writing—review and editing: S-LC, S-WY.



Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology and Head and Neck SurgeryChang Gung Memorial HospitalLinkouTaiwan
  2. 2.School of MedicineChang Gung UniversityTaoyuanTaiwan
  3. 3.Department of Otolaryngology and Head and Neck SurgeryChang Gung Memorial HospitalKeelungTaiwan

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