Comparison of canal wall incisions for tympanoplasty for large central perforations

Abstract

Aim and Objective: To compare surgical outcomes with different canal wall incisions used in common practice for tympanoplasty for large perforations. Materials and Methods: Totally 88 patients included in the study and three groups formed. Group A consisted of 35 patients and the vascular strip incision with anterior tucking (VSAT) technique used in these patients. Group B consisted of 31 patients and the tympanometal flap with anterior tucking (TMFAT) technique used in these patients. Group C had 22 patients and the near full cuff (NFC) technique used in them. Results: Success rate of 97.15% observed for Group A, 93.55% observed for Group B and 86.36% observed for Group C patients. Most of the patients in Group A had healing time <4 weeks, whereas most patients in Group C had more than 5 weeks of healing time. Granulations were not seen in Group A, whereas 3 among Group B and 4 among Group C patients developed granulations. Canal wall sagging was seen in 1 among Group A, 2 among Group B and 4 among Group C patients. The average hearing gain in terms of improvement in air-bone gap for Groups A, B and C have been 19.62, 19.25 and 17.35 db, respectively. Conclusion: The VSAT is the method of choice in terms of better success rates and minimum canal skin related complications in postoperative period. The VSAT also provides good exposure during surgery. Hearing gain in Group A is significantly better than Group C (P = 0.023).