EFFECTS OF A FOCUS OF INFECTION IN THE UPPER RESPIRATORY TRACT ON THE OUTCOME OF MYRINGOPLASTIES

Objective: To determine whether performing myringoplasty in patients having anatomical or physiological dysfunction in the upper respiratory tract (URT) has any effect on the postoperative results of myringoplasty.Methodology: This quasi-experimental study was conducted at PNS Shifa and CMH Okara, from August 2005 to July 2009. A total of 250 patients, 56% males and 44% females who underwent myringoplasty were included in the study.Medium to small sized central perforations were operated. Patients were separated into two groups. Group A (n-150)had dry central perforations with no deflected nasal septum (DNS), sinusitis, tonsillitis or nasal polyp. Group B (n100) had dry central perforations with mild to moderate DNS, history of tonsillitis, nasal allergy and sinusitis. Both groups were operated and followed up for 01 year. Data collected was analyzed by SPSS windows version 14.Results: Out of 250 operated cases 56% were males and 44% were females with male to female ratio of1.2:1. Age ranged from 12-35 years with mean age of 22.4+5 years. After one year of follow up, 128/150 (85.33%) patients in group A had intact graft with improved hearing standards up to 25dbs as compared to 60/100 (60%) patients in group B (p 0.001). Forty patients with graft failure had a history of an attack of upper respiratory tract infection resulting in ear discharge and graft failure.Conclusion: Anatomical or physiological dysfunction in the URT due to DNS, tonsillitis, nasal allergy and sinusitis adversely affect the outcome of myringoplasty and should be addressed first before performing myringoplasty.