Clinical and economic evaluation of minimally invasive cartilaginous palisade myringoplasty

Abstract

Objectives: To test the clinical and audiometric efficacy of a minimally invasive myringoplasty technique, combining cartilaginous palisades while avoiding flap elevation, for small and wide perforations.

Methods: Over 4 years, this retrospective study included all patients over 6 years of age presenting an indication for myringoplasty. Several clinical and economic criteria were noted at 7 d, 2 months, 6 months and 2 years postoperative. The main outcome was the absence of perforation 2 years postoperative. The secondary outcomes were an audiometric gain at 6 months and the evaluation of the treatment cost.

Results: Thirty patients underwent the minimally invasive technique and 28 patients the technique with an elevation of the tympanomeatal flap. The minimally invasive surgical procedure was shorter (p = .001). At 2 years, the tympanic closure rate was equivalent (95% versus 89.5%, p = .77). The audiometric gain was similar between the two techniques (p = .09). From a medico-economic point of view, the minimally invasive procedure was the most effective because it was three times less expensive than the conventional technique with no reduction in efficacy (p = .02).

Conclusion: This quick and easy technique could be developed in an ambulatory setting or even in conditions adapted to consultation.

Chinese abstract

目的：测试用于小而宽的穿孔的微创手术成像技术的临床和听觉功效。此技术结合软骨栅栏, 同时避免瓣膜抬升。

方法：这项回顾性研究为时四年, 包括所有6岁以上的提出使用成像技术的意愿的患者。术后7 天、2个月、6个月和2年时均记录了临床和经济标准。主要结果是术后2年无穿孔。次要结果是6个月时的听力改善和治疗费用评估。

结果：30例患者接受了微创手术, 28例患者接受了鼓室气孔瓣抬升术。微创外科手术术程较短（p = 0.001）。 2年时, 两种手术的鼓膜闭合率相当（分别为95%和89.5%, p = .77）。两种技术之间的听力增益相似（p = 0 .09）。从医学经济的观点来看, 微创手术是最有效的, 因为它比常规技术便宜3倍, 而效应没有降低（p = 0.02）。

结论：这种快速简单的医术可以在流动医疗室中, 甚至可以在改进的门诊室中使用。

Keywords:

• Audiometry
• myringoplasties
• otologic surgical procedures
• clinical otology
• cartilage palisades

Disclosure statement

The authors declare that they have no conflict of interest. No grant.