{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:52:19Z","timestamp":1777877539869,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Wenzhou Municipal Science and Technology Bureau, China","award":["Y20240326"],"award-info":[{"award-number":["Y20240326"]}]},{"name":"Zhejiang Provincial Clinical Research Center for Pediatric Diseases,China","award":["ZJEK2310Y"],"award-info":[{"award-number":["ZJEK2310Y"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Trimming perforation margins (TFMs) is a classic procedure of myringoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate the long-term graft outcomes and iatrogenic cholesteatoma of endoscopic cartilage myringoplasty with preserving perforation margins (PFMs) for repairing small- to medium-size perforation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Prospective semi-randomly control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary university hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with chronic small- to medium-size perforations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>TFM group or the PFM group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Comprehensive evaluations included graft success rate, hearing improvement, and imaging examinations at 3, 6, and 36\u2009months after surgery and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At postoperative 3\u2009months, the graft success rate was 91.84% in the TFM group and 96.30% in the PFM group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.59). At postoperative 6\u2009months, graft separation resulted in re-perforation in 3.70% patients in the PFM group, and the graft success rate was 91.84% in the TFM group and 92.59% in the PFM group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.82). At postoperative 3\u2009years, the graft success rate was 93.88% in the TFM group and 94.44% in the PFM group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.77). Although postoperative air bone gaps (ABGs) were not significantly different between 2 groups, the PFM group had better hearing restoration compared with the TFM group in postoperative 3\u2009months or 3\u2009years. Additionally, although no significant differences were found in the ABGs between postoperative 3\u2009months and postoperative 3\u2009years in any group, postoperative 3\u2009years showed better hearing restoration compared with postoperative 3\u2009months. In addition, endoscopic morphology showed the graft stratification in .00% in the TFM group and 11.11% in the PFM group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.05). Postoperative high-resolution computed tomography (HRCT) revealed a few soft tissue shadow in 8.16% patients in the TFM group and in 5.56% patients in the PFM group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.89); middle ear cholesteatoma was excluded by magnetic resonance imaging. However, HRCT revealed that the middle ear and mastoid were well pneumatized in the remaining patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and relevance<\/jats:title>\n                    <jats:p>The long-term graft success rate and hearing improvement of cartilage underlay myringoplasty with PFMs are reliable for repairing small- to medium-size perforations; 3\u2009years imaging examinations did not reveal iatrogenic cholesteatoma. However, it may cause graft stratification and graft separation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251398768","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T14:56:02Z","timestamp":1764428162000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Imaging Examination of a Three-Year Follow-up of Cartilage Underlay Myringoplasty with Preserving Perforation Margins for Repairing Small- to Medium-Size Perforation"],"prefix":"10.1177","volume":"54","author":[{"given":"Xuefei","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqiong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruoqi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0130-9952","authenticated-orcid":false,"given":"Xuejun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00454257"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12014"},{"key":"e_1_3_2_4_2","article-title":"Graft healing process following cartilage myringoplasty without trimming of the perforation margin","author":"Wu M","unstructured":"Wu M, Lou Z. 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