Correlation between the perforation size and patency of eustachian tube and graft uptake in intact canal wall tympanoplasty surgery: a study of 32 benign-type chronic suppurative otitis media patients

Abstract

Background: Factors that contribute to the success of Intact canal wall Tympanoplasty have yet to be certainly known. Several studies show varied success rates and success criteria. Objective: To investigate the correlation between the perforation size and patency of Eustachian Tube and the results of graft uptake on benign-type chronic suppurative otitis media patients that undergo intact canal wall tympanoplasty surgery. Methods: This research used observational descriptive analysis. The participants were patients diagnosed with benign-type chronic suppurative otitis media who were treated with intact canal wall tympanoplasty surgery in 2018. Data such as demographic data, smoking history, clinical findings including perforation size of tympanic membrane, Eustachian Tube patency, results of pure-tone audiometry examination, results of graft uptake, and type of Tympanoplasty were collected from each participant. The statistic tests in use included contingency coefficient correlation test and Fisher exact test. Result: Most of the participants were male (53.13%), the average age was 28.03 ± 12.32 years old, and most participants do not smoke (71.87%). The overall graft uptake success rate is 71.87% (n = 23), while the failure rate is 28.12% (n = 9). Pure Tone Average (PTA) was 37.19 dB at pre-op and 25.79 dB at post-op, which is a significant improvement (p=0.000) with average hearing improvement (PTA-Gain) of 15.75 dB. The patent Eustachian Tube functions give the best graft uptake results of 88.90%, followed by partial patency at 75% and non-patent at 40% (p=0.020). The highest average of PTA in non-patent function of the tube is 20.94 dB. Hearing threshold improvement (PTA-Gain) on patent, partial, and non-patent ETF groups differs signifi-cantly (p=0.046). Results of graft uptake on small and medium perforation size show the highest rate of (81.80%), followed by large perforation (50%). The highest PTA in total perforation size is (18.90 dB), then medium (15.14 dB), and small (6.22 dB). The perforation size of TM before surgery does not correlate with the success of graft uptake (p=0.297). The size of perforation correlates with improvement of hearing threshold (p=0.011). Conclusion: Eustachian Tube’s function has correlation with the success of graft uptake and hearing threshold improvement (PTA-Gain), while the perforation size of TM before surgery correlates with hearing threshold improvement (PTA-Gain).