An evaluation of myringoplasty in war injured people

Silicon foil patching for blast tympanic membrane perforation: a retrospective study

Aim

To establish whether covering the tympanic membrane perforation after war blast injury with silicon foil can enhance the ear drum healing rate and to determine the appropriate timing of silicon patching.

Methods

We retrospectively analyzed the charts of 210 patients wounded during the Homeland War in Croatia 1991-1995, with 315 blast tympanic membrane perforations. In 44 patients (61 perforations), the eardrum perforation was covered by silicon foil, whereas in 166 patients (254 perforations) it was left to heal spontaneously. The patients who underwent the patching procedure were divided in two groups according to the time period between the blast injury and the procedure: 38 perforations were treated within 3 days and 23 perforations were treated 4 to 6 days after the blast injury.

Results

The rate of tympanic membrane healing in the silicon foil patching group was significantly higher (91.8%) than that in the group of perforations left to heal spontaneously (79.9%, P = 0.029). The healing rate was significantly higher in the group treated within 3 days after the blast injury (97.4%) than in the group treated 4 to 6 days after the injury (82.6%, P = 0.042).

Conclusion

Covering the perforation after the war blast injury with silicon foil significantly improves the rate of tympanic membrane healing. To obtain the best healing outcome, the procedure should be performed within the first 72 hours after the trauma.

Myringoplasty with temporalis fascia : Analysis of 200 cases

Two hundred cases of chronic suppurative otitis media with dry ear were taken up for myringoplasty operation by underlay technique through transcanal route. Autologous temporalis fascia was used as the graft material in all cases. Surgery was done during the period from April 1987 to November 1992. The patients were reviewed 5 years after the surgery [1997] and analysed.