Otology & Neurotology

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Otology & Neurotology:
doi: 10.1097/01.mao.0000231503.92275.12
Middle Ear & Mastoid Disease

Epithelial Migration of the Postmyringoplasty Tympanic Membrane

Deong, Kee Kong; Prepageran, Narayanan; Raman, Rajagopalan

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Objective: To determine whether the postmyringoplasty tympanic membrane (TM) behaves in a similar way compared with a healthy nonoperated eardrum by calculating and comparing the epithelial migration rate and pattern.

Study Design: Prospective, nonrandomized case-control study. Each subject who has undergone a myringoplasty and with healthy contralateral TM as control is included in this study.

Setting: Otolaryngology outpatient clinic.

Patients: A total of 23 subjects with 46 ears have been selected from otolaryngology outpatient clinic of the University Malaya Medical Center after excluding two subjects from this study. The study was conducted from June 2003 to September 2004.

Intervention: All the selected subjects' ears were examined under a microscope. Methylene blue ink dot was applied to the epithelium of the TM at the immediate vicinity of the umbo; then, weekly follow-up was performed until the migratory pattern and the rate of epithelial migration was noted.

Main Outcome Measure: Direction and rate of epithelial migration in both study and control group were measured and compared.

Results: Epithelial migration did occur in postgrafted TM, from the umbo region toward the ear canal wall in a lateral radiating manner. Most of the patients (19 of 23 patients [82.6%]) showed nearly similar migratory pattern (same direction) in both the control and the study ear. None of the 46 ears showed any evidence of epithelial migration in the anteroinferior direction of TM. The rate of migration was slower in the beginning, especially near the umbo region (almost no movement at the first 1 or 2 weeks after ink dot application). For both groups, the rate of migration increased when approaching the periphery or annulus region. There was not much difference in the mean daily migratory rate between the control and the study ear (93.4 μm/d and 91.7 μm/d, respectively). The mean migratory rate was highest in subtotal perforation (97.2 μm/d) and lowest in small perforations (<20%; 83.6 μm/d).

Conclusion: There was no difference in epithelial migration rate and pattern between the postmyringoplasty TM and the healthy TM.

© 2006 Otology & Neurotology, Inc.

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