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Abstract Influence of myringosclerosis on the outcome of myringoplasty Many controversies exist on ideal way of treating tympanic membrane perforations with myringosclerotic patch in tympanic membrane remnant, whether to leave or remove the patch and if it is removed does this aids some benefit to the patient or it is not worthy. This study was done to compare myringoplasty surgery in patients with myringosclerosis in tympanic membrane remnant in two groups of patients, randomly subdivided with matching between both groups as much as possible. The study included 30 patients from outpatient clinic at Alexandria University Hospital subdivided into 2 groups. Group A Included those patients who underwent myringoplasty only. Group B Included those patients who underwent myringoplasty with removal of myringosclerotic patch. All patients were evaluated by full medical history ,full clinical examination which included precise examination of ear, nose and throat and excluded patients, were those with history of a previous middle ear surgery or with unhealthy middle ear mucosa e.g. adhesions, granulations or cholesteatoma, debilitated patients as diabetics or patients on systemic steroids and those with tympanosclerotic fixation of the ossicles if discovered intraoperatively . All surgeries were done by same surgeon (the supervisor) and same technique of myringoplasty. All patients were followed up weekly for the first month and then monthly for 6 months. The graft take was 100% taken In all patients until the end of the follow up period. Hearing assessment was done after third month using the pure ton ethresholds for hearing at frequencies 250 up to 8000hz and mean pure tone averages at frequencies 500,1000, and 2000hz for air conduction and bone conduction was calculated as well as air bone gap for both groups. In group B the hearing gain was slightly higher by % of improvement as evidenced by MANN WHITNEY test as P =0.014. |