Evaluating the Necessity of Ear Packing After Otologic Surgery: A Randomized Controlled Trial.

Objective: This study aims to evaluate the necessity of ear packing in otological operations where the annulus fibrosus is not elevated, focusing on graft success rates and postoperative hearing outcomes.

Methods: A randomized controlled prospective clinical trial was conducted at a tertiary care hospital involving 200 patients aged 18 years and above undergoing myringoplasty for inactive chronic suppurative otitis media. Patients were randomly assigned to receive either ear packing with absorbable gelatin sponge (Gelfoam®) or no packing. The primary outcome is graft success assessed via microscopic examination at 3 and 6 months post-surgery. Secondary outcomes include hearing gains measured by pure-tone audiometry at 500-, 1000-, 2000-, and 4000-Hz frequencies.

Results: At 3 months, the graft take rate was 92% in the ear packing group and 90% in the no packing group, with no statistically significant difference ( p = 0.63). At 6 months, the graft take rate was 90% in the packing group and 88% in the no packing group ( p = 0.67). Hearing improvements, as measured by air conduction thresholds, were also similar between the two groups ( p = 0.73).

Conclusion: This study demonstrates that myringoplasty without ear packing yields comparable graft take rates and hearing improvements to traditional myringoplasty with ear packing. These findings suggest that omitting ear packing in appropriate cases may simplify the procedure without compromising patient outcomes.