Outcome Measurement Between Transtympanic and Tympanomeatal Flap Elevation Approach in Myringoplasty: A Day Care Procedure

Abstract

Background: Transtympanic myringoplasty is an alternate technique that allows graft placement medial to tympanic membrane remnant through the perforation without the need for tympanomeatal flap elevation. Objectives: The aim of this study is to evaluate the efficacy and compare the results of transtympanic myringoplasty without tympanomeatal flap elevation with the usual method of graft placement by the elevation of a tympanomeatal flap. Materials and Methods: This is a prospective study done on fifty patients divided into two groups, each consisting of 25 patients. Group I patients underwent transtympanic myringoplasty without elevation of tympanomeatal flap and group II patients underwent tympanomeatal flap elevation myringoplasty. Both the procedures were done by underlay technique through transcanal approach using only tragal perichondrium as graft material. Results and Observations: Graft uptake was successful in 88% and 92% ears while hearing improvement was seen in 84% and 91.3% in the group I and II patients respectively. The mean hearing gain was 15.04 dB and 15.57 dB in group I and II respectively. Conclusion: Transtympanic myringoplasty is a simple and less traumatic yet equally effective approach for the repair of tympanic membrane perforation. It has the added advantages of minimal post-operative pain, cost-effectiveness, no potential risk of injury to chorda tympani and results comparable to conventional techniques of myringoplasty.