Effect of Packing Versus No Packing in Transperforation Myringoplasty for Chronic Tympanic Membrane Perforations

Abstract Objective To compare the operation times, graft survival and success rates, audiometric outcomes, and complications of patients who underwent transperforation myringoplasty with and without packing but without perforation rimming. Study Design A prospective, randomized controlled trial. Setting A university‐affiliated teaching hospital. Methods We conducted a randomized controlled trial that enrolled patients who underwent underlay myringoplasty. No patient underwent perforation rimming. Patients underwent myringoplasty with or without graft lateral packing. The operation times, graft survival and success rates, audiometric outcomes, and complications were compared between the 2 groups. Results Sixty patients with unilateral perforations were included. The mean neovascularization score at postoperative week 2 was significantly higher in the no‐packing group than in the packing group ( p < .01) but did not differ significantly at postoperative weeks 3 and 4, or postoperative month 3. Neither the graft healing rate ( p = .313) nor the perforation closure rate ( p = .640) significantly differed between the 2 groups. The mean air‐bone gap improved by 8.91 ± 5.45 dB in the packing group and 8.17 ± 1.19 dB in the no‐packing group ( p = .758). Conclusion The long‐term graft success and hearing improvements in transperforation myringoplasty with no rimming of the perforation and no‐graft lateral packing were comparable to those in the graft lateral packing group with no rimming of the perforation, with a low incidence of complications. These results may change the traditional practice of packing the external auditory canal and rimming the perforation in underlay myringoplasty, even for all myringoplasty surgery.