Original Article

Permeatal ‘push through’ myringoplasty in the Northern Territory: a prospective cohort

Tze Ling Loh, Sebastian Ranguis, Hemi Patel, Graeme Crossland


Background: The permeatal cartilage ‘push through’ tympanoplasty is a safe and effective technique that has previously been shown to be beneficial in a variety of settings. This study examines its efficacy in a population with high proportions of Indigenous Australians who live in remote areas and have a high burden of chronic suppurative middle ear pathology.
Methods: Multi-centre prospective case series. Two hundred and forty-one patients underwent transcanal “push-through” myringoplasty in the Northern Territory of Australia between January 01, 2012 and January 01, 2014. Graft integrity, air-bone gap closure and pure-tone average (PTA) thresholds were recorded at 1–5 months post operatively and after 12 months.
Results: At 1–5 months, 87.2% of patients had successful grafts and intact tympanic membranes. Beyond 12 months, 84.4% of patients continued to have intact grafts and tympanic membranes. Less than 20% of patients had a residual hearing loss of more than 30 dB after the surgery. The air-bone gap was significantly lower after surgery (P<0.001).
Conclusions: ‘Push Through’ myringoplasty has a favourable success rate when compared to conventional methods employed in the Aboriginal population (30–64%) and provides the patient with a safe ear and improved hearing.

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