الفهرس 
Historical reviewOnly 14 pages are availabe for public view
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Abstract
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 60 patients from outpatient clinic at El Menoufia University Hospital subdivided into 2 groups A & B, B-group was subdivided into 2 subgroups; each of these groups included 20 patients. Group A Included those patients who underwent myringoplasty only. Group B Included those patients who underwent myringoplasty with removal of myringosclerotic patches which are less than one third of tympanic membrane surface area (group B1 ) or more than one third of the tympanic membrane surface area (group B2). 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 car mucosa e.g. adhesions, granulations or cholesteatoma, upper respiratory tract infection 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 85% taken in group A and 90% taken in group B patients until the end of the follow up period. Hearing assessment was done after third month using the pure tone thresholds for hearing at frequencies 250 up to 8000 Hz and mean pure tone averages at frequencies 500, 1000, and 2000 Hz 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 as evidenced by Independent Sample T-test as P =0.007.