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Otology/Neurotology

(162) Effect of the Microbiome on Tympanoplasty Healing

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Kevin M. Chacko

    Medical Student
    University of Florida College of Medicine
    Gainesville, Florida, United States

    • Co-Author(s)

  • CD

    Carolyn O. Dirain, PhD

    Associate Scientist
    University of Florida
    Gainesville, FL, United States

    • Senior Author(s)

  • Patrick J. Antonelli, MD, MS

    Professor of Otolaryngology, Neuroscience, and Speech, Language, and Hearing Sciences
    University of Florida
    Gainesville, FL, United States

Disclosure(s):
Kevin M. Chacko: No relevant relationships to disclose.
Patrick J. Antonelli, MD, MS: No relevant relationships to disclose.


Introduction: Studies investigating the effects of the ear microbiome on tympanoplasty healing are limited. The purpose of this study is to see if Staphylococcus aureus or Pseudomonas aeruginosa colonization is associated with suboptimal healing after tympanoplasty.

Methods: Patients that underwent tympanoplasty for chronic TM perforation in the summer of 2017 were prospectively enrolled. Specimens of the TM and adjacent ear canal and middle ear mucosa were collected at surgery for selective S. aureus and P. aeruginosa culture. Health records were reviewed at 5 years postoperatively for TM healing outcomes. Descriptive statistics and Chi-square test of independence were performed with p-values < 0.05 considered significant.

Results: 14 of 23 subjects were female and 6 had prior tympanoplasty. 5 of 23 yielded S. aureus and 4 yielded P. aeruginosa. The presence of S. aureus was associated with both granulation tissue (2-6 months, p = 0.010; 1-2 years, p = 0.007) and TM perforation (2-6 months, p = 0.037; 1-2 years, p = 0.011) after tympanoplasty. P. aeruginosa was not associated with adverse healing.

Conclusions: Colonization of the TM, adjacent canal, and middle ear with S. aureus may lead to suboptimal healing with tympanoplasty for TM perforation. The potential to improve tympanoplasty healing by preoperative management of the ear microbiome warrants investigation.