Long-term Persistence of Tympanic Membrane Perforation following Myringotomy: A Three-Year Follow-up Study

Background: Myringotomy is a common otologic procedure performed to relieve middle ear effusion and improve ventilation. The tympanic membrane incision typically heals spontaneously; however, persistent perforation may occur, leading to recurrent infections, hearing impairment, and a potential need for surgical repair. Long-term data on this complication in resource-limited outpatient settings remain limited.
Objective: To determine the rate and associated factors of long-term persistence of tympanic membrane perforation three years after myringotomy.
Methods: This follow-up study was conducted in the private chamber of a registered physician in Bangladesh from January 2019 to December 2024. A total of 120 patients who underwent myringotomy were included using purposive sampling. Otoscopic and audiological evaluations were performed periodically, and membrane status at three years was the primary outcome. Data were analyzed using SPSS version 23.0.
Results: The mean age was 24.6 ±12.3 years; 58.3% were male. Persistent tympanic membrane perforation at three years was observed in 14 patients (11.7%). Higher persistence was significantly associated with recurrent otitis media (OR =3.21, p=0.01), large initial incision size (OR =2.87, p=0.02), and postoperative infection (OR =3.54, p=0.004). Most persistent perforations were central (71.4%). Patients with persistent defects had significantly greater mean conductive hearing loss (28.5 ±6.2 dB vs 16.1 ±5.4 dB, p<0.001).
Conclusion: Although most myringotomy incisions heal, a notable minority develop long-term perforation.
Careful surgical technique and infection control may reduce the risk.