Is there any advantages of using methylene blue in myringoplasty? To compare the results of methylene blue stained temporalis fascia graft with unstained temporalis fascia graft in underlay myringoplasty.

In this prospective study, 120 patients of either sex in age group of 15 to 50 years with non-cholesteatomatous chronic suppurative otitis media (CSOM) were recruited. Patients were initially managed medically to make the ear dry and after that they were operated upon. Sixty patients underwent underlay myringoplasty using methylene blue stained temporalis fascia graft and 60 patients underwent underlay myringoplasty using unstained temporalis fascia graft. Follow-up period was at least 6 months.

Graft uptake and hearing improvement was comparable in both groups. Although there was 10% higher graft uptake using methylene blue stained temporalis fascia (95%) as compared to unstained temporalis fascia graft (85%), however the difference was not statistically significant (p = 0.5). But there was statistically significant difference in gain in hearing threshold (gain in air-bone gap) in the myringoplasty using methylene blue stained temporalis fascia graft (18 dB ± 7.156) as compared to myringoplasty using unstained temporalis fascia graft (13.7 dB ± 5.70814) (p = 0.04).

Methylene blue use in myringoplasty allows improved identification of the graft, can be very helpful for trainee residents and reduce the time of a graft placement. Also, methylene blue as an antioxidant and antimicrobial properties, prevents degradation and lysis of fascia graft, improves the overall success rate of graft uptake with no adverse effects.

Kathuria B, Dhingra H, Gulia J, Kakkar V, Yadav SPS, Hernot S, Bishnoi S. Staining in Tympanoplasty: Is Methylene Blue Rational? Int J Otorhinolaryngol Clin 2015;7(3):125-131.