(809) Association Between Recent Otorrhea and Persistent Tympanic Membrane Perforation After Tympanoplasty

Introduction: Tympanoplasty (TP) is performed to repair tympanic membrane (TM) perforations, yet persistent perforation remains a clinically important failure outcome. This study assessed whether otorrhea within three months prior to TP is associated with increased risk of persistent TM perforation ≥6 months after surgery.

Methods: A retrospective cohort study was performed using the TriNetX research network. TP without mastoidectomy or ossicular chain reconstruction was identified using CPT 69631 (index date = procedure). Patients were categorized by the presence or absence of otorrhea within 3 months prior to the index event using ICD-10-CM codes H92.10–H92.13. Persistent TM perforation ≥6 months after TP was identified using ICD-10-CM codes H72.0–H72.9. Propensity score matching was conducted 1:1 based on age, sex, race, and ethnicity.

Results: Prior to matching, patients with preoperative otorrhea had a similar mean age compared with those without otorrhea (33.5 ± 23.3 vs 33.0 ± 22.9 years), and sex distributions were comparable between groups (female: 1,200 [51.2%] vs 15,628 [52.6%]). After propensity score matching, 2,345 patients were included in each cohort with well-balanced baseline characteristics. Persistent TM perforation occurred in 488 patients (20.8%) with otorrhea and 386 patients (16.5%) without otorrhea. Otorrhea was associated with a significantly increased risk of persistent perforation following TP (risk difference 4.35%, 95% CI 2.12–6.58%; risk ratio 1.26, 95% CI 1.13–1.42; p< 0.001).

Conclusions: These findings suggest that recent preoperative otorrhea may serve as a clinical risk marker when planning perioperative management for TP. This has implications for patient counseling and shared decision-making.