Impact of Epithelial Inflammation of the Membrane Remnant on the Outcome of Tympanoplasty

Background: Chronic otitis media (COM) with tympanic perforation sometimes requires tympanoplasty. Many factors can interfere with surgical success; however, the histological status of the remaining epithelium of the perforation has not been studied as a risk factor for surgical failure. Methods: Observational, longitudinal, analytical study in patients with COM, candidates for tympanoplasty who met the inclusion criteria between August and December 2024. Tympanoplasty was performed and the tympanic ring epithelium was sent for histological analysis. After 30 days, closure or non-closure of the perforation was determined and the results were collected. Descriptive and analytical statistics were performed according to the data distribution using the SPSS 26.0 statistical package. Results: Twenty subjects were included; 80% with tubal dysfunction, 60% central perforation, and 65% medium-sized. 13 were successful and 7 failed. Histopathological analysis revealed dystrophic calcification, chronic lymphocytic infiltrate, histiocytic infiltrate, fibrosis, loose keratin sheets, metaplasia, and spongiosis. The logistic regression model showed an OR of 7.3 for marginal perforation and 3.4 for the OPSS score. Of the patients with surgical failure, 57.4% had epithelial inflammation. Conclusions: Epithelial inflammation affected surgical success in more than 50%.