Graft uptake and hearing assessment in revision myringoplasty in a tertiary centre


  • Pabina Rayamajhi Department of ENT-HNS, TUTH, Institute of Medicine, Kathmandu
  • Heempali Das Dutta Department of ENT-HNS, TUTH, Institute of Medicine, Kathmandu, Nepal
  • Kripa Dangol Department of ENT-HNS, TUTH, Institute of Medicine, Kathmandu, Nepal
  • Bijaya Kharel Department of ENT-HNS, TUTH, Institute of Medicine, Kathmandu, Nepal



Air conduction threshold, Air bone gap, Graft uptake, Cortical mastoidectomy, Revision myringoplasty


Background: The revision myringoplasty surgery is done for the graft failure after myringoplasty. The surgeons’ make use of the temporalis fascia or cartilage as the graft material. Some surgeons opt for the revision myringoplasty with cortical mastoidectomy as well.

Methods: This study is a retrospective, observational study done in the Department of ENT and Head and Neck Surgery, Tribhuvan University Teaching Hospital from December 2015 to 2019. Data of all the patients undergoing revision myringoplasty with or without cortical mastoidectomy were collected from the record section and included in the study. Post-operatively, the patients were assessed for graft uptake and hearing assessment after six weeks of surgery. Total uptake of the graft was taken as the successful graft uptake. The hearing was assessed by air conduction threshold (AC threshold) and air-bone gap status postoperatively.  

Results: Total of 42 patients were analysed with the graft uptake of 86%. There was no significant difference in the graft uptake on using the temporalis fascia or tragal cartilage. Regarding the hearing assessment, the average pre-operative and post-operative AC threshold was 37.95±5.68 dB and 29.36±6.28 dB. The average pre and postoperative AB gap was 29.97±8.16 dB and 21.85±6.68 dB. The improvement in the hearing threshold was significant (p value <0.05).

Conclusions: The graft uptake rate for revision surgery in our centre was comparable to other studies in the literature. There was significant hearing improvement pre and postoperatively after revision myringoplasty.


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