Predictors of surgical and hearing long-term results for inlay cartilage tympanoplasty

Objective: To determine the prognostic factors that affect surgical and audiologic outcomes in inlay tympanoplasty after long-term follow-up. Design: Case series study. Setting: Tertiary referral center. Patients: Sixty-two patients who underwent 71 procedures were enrolled in the study. Patient ages ranged from 31 to 87 years (mean [SD] age, 61.2 [12.9] years). Mean (SD) follow-up was 635.7 (284.7) days. The inclusion criteria were (1) inlay cartilage tympanoplasty performed using local anesthesia via a transcanal route, (2) chronic otitis media with stable perforation, and (3) dry ear without middle ear disease. Main Outcome Measures: The success rate and hearing change at the last follow-up visit. Results: The overall success rate was 87.3% at the last visit. Using multivariate analysis, sex, age, size of perforation, side of perforation, and the presence of diabetes mellitus and external auditory canal otomycosis did not affect the success. Smoking was the only independent factor for the prognosis of surgical outcome (odds ratio [OR], 8.16; 95% confidence interval [CI], 1.74-36.89; P<.006). On the other hand, age (OR, 6.62; 95% CI, 1.13-38.47; P=.03) and perforation size (OR, 0.11; 95% CI, 0.10-0.79; P=.03) were independent factors for the prognosis of audiologic outcomes. Conclusions: The frequency of failure was significantly higher for smokers than for nonsmokers. To quit smoking is highly recommended preoperatively for individuals scheduled for chronic otitis media inlay tympanoplasty intervention. Younger patients and those with larger perforations (>50%) were more likely to benefit from this operation.