{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:50:42Z","timestamp":1791935442977,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","award":["SLS\u2010998787"],"award-info":[{"award-number":["SLS\u2010998787"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Risk factors for unsuccessful healing of a tympanic membrane perforation following myringoplasty lack consensus. Large cohort studies are missing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected for myringoplasties (with\/without concomitant ossiculoplasty) performed the years 2014\u20132019 with a follow\u2010up visit using the Swedish Quality Register for Ear Surgery (SwedEar). Risk factors for unsuccessful surgical outcome, defined as non\u2010healed tympanic membrane at follow\u2010up, were calculated using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population included 3622 cases and 12.8% had a non\u2010healed tympanic membrane at follow\u2010up. The most commonly used graft material was fascia, used in 94.6% of the cases. Of the analysed variables, prior ear surgery (adjusted (a)OR 1.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), age younger than 8\u2009years (aOR 1.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), a postoperative infection within 6\u2009weeks after surgery (aOR 1.92,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and the surgical aim of achieving a dry\/infection free ear (aOR 1.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045) were predictors for unsuccessful healing. For simultaneous ossiculoplasty at surgery, there was a significantly higher chance of having a healed tympanic membrane (aOR 1.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). For other variables such as gender, operated side, season, graft material, perioperative antibiotics and infection free status at surgery, there was no significant effect on tympanic membrane healing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present evaluation of the surgical results in SwedEar constitutes one of the largest studies on myringoplasty outcome. The results showed that the age of the patient, surgical aim, prior ear surgery and postoperative infection constituted risk factors for unsuccessful healing after myringoplasty. Surprisingly, ears requiring a concomitant ossiculoplasty had a higher healing rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70176","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:36:23Z","timestamp":1791934583000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unsuccessful Healing of Tympanic Membrane Perforations Following Myringoplasty\u2014A Nationwide Retrospective Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5525-2497","authenticated-orcid":false,"given":"Elnaz","family":"Sepehri","sequence":"first","affiliation":[{"name":"Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Ear, Nose and Throat Diseases Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2584-0941","authenticated-orcid":false,"given":"Julia","family":"Arebro","sequence":"additional","affiliation":[{"name":"Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Ear, Nose and Throat Diseases Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5472-4085","authenticated-orcid":false,"given":"Eva","family":"Westman","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Otorhinolaryngology Ume\u00e5 University  Sundsvall Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1434-4771","authenticated-orcid":false,"given":"Per Olof","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Otorhinolaryngology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0036226"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211062153"},{"key":"e_1_2_12_4_1","volume-title":"Chronic Suppurative Otitis Media: Burden of Illness and Management Options","author":"Health O W.","year":"2004"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26523"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988809800211"},{"issue":"4","key":"e_1_2_12_7_1","first-page":"229","article-title":"Retrospective Analysis of Surgical Outcome, Symptom Changes, and Hearing Improvement Following Myringoplasty","volume":"29","author":"Bhat N. 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