ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Factor-based reperforation timing after tympanoplasty: a graft survival analysis.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the impact of risk factors on the timing of reperforation (RP) after tympanoplasty and to determine the optimal follow-up intervals.
methodsThis retrospective study included 403 patients who underwent tympanoplasty with at least 2 years of follow-up. The patients were divided into RP (n = 32) and non-RP (n = 371) groups. Data on age, sex, BMI, diagnosis of diabetes mellitus, smoking, atopy, perforation size and type, and middle ear status were collected based on factors previously reported to affect the graft outcomes. Group comparisons were made to identify factors associated with RP. Time-to-event analysis (Kaplan–Meier) was used to assess the effect of variables on RP timing, and linear regression was conducted to determine predictors of shorter RP time.
resultsOf 403 patients, 32 experienced RP. Larger (> 50%), marginal perforations, diabetes mellitus, and smoking were significantly associated with RP. Marginal perforations (11.56 ± 5.73 months), diabetes mellitus (10.72 ± 5.09 months), and smoking (11.83 ± 4.79 months) individually led to significantly shorter RP times. The coexistence of smoking, diabetes mellitus, and marginal perforation resulted in the shortest mean RP time (6.58 ± 4.14 months). Linear regression confirmed diabetes mellitus as a significant predictor of a shorter RP time (B = -3.161, p = 0.049).
conclusionOur findings show that marginal perforations, diabetes mellitus, and smoking not only increase the risk of RP, but also significantly accelerate its timing, especially when combined. This requires closer and tailored postoperative monitoring for high-risk patients to improve the long-term success of tympanoplasty. Level of evidence: 4
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