SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
OBJECTIVES: The aim of this study was to determine the success rate of myringoplasty surgery performed at Groote Schuur Hospital and to evaluate some of the presumed prognostic factors. DESIGN: The study design was a retrospective analytical cohort. SETTING: Groote Schuur Hospital (tertiary medical centre), Cape Town. SUBJECTS: This study assessed the success rate of 341 myringoplasty operations performed by surgeons in the Department of Otolaryngology from January 2005 to December 2009. OUTCOME MEASURES: An unsuccessful operation was classified as a residual perforation seen at the 3-month follow-up visit that remained present at all subsequent visits. Presumed prognostic factors such as the rank of the surgeon, size of the perforation, location of the perforation, graft used and whether it was a revision procedure, were also evaluated. Where possible, the audiometric gain following surgery was calculated. RESULTS: The overall success rate in terms of an intact tympanic membrane following myringoplasty was 71%. The average improvement in pure tone average following myringoplasty was 12.4 dB. In 64% of patients, socially acceptable hearing levels were present postoperatively (air-conduction of less than 30 dB). None of the presumed prognostic factors was a statistically significant determinant (p>0.05). CONCLUSION: The success rate for myringoplasty (in terms of perforation closure) of 71% at Groote Schuur Hospital compares well with that quoted in the literature. There is no ethical dilemma from a surgical outcomes perspective of registrars performing myringoplasties.