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Abstract
Objective: The objective of the study is to compare circumferential versus anterior tucking underlay tympanoplasty technique. Methods: In this prospective observational study, 100 patients with chronic otitis media (Inactive mucosal type) were included, who were randomly allocated in two groups; Group I which comprised of 50 patients in which tympanoplasty with anterior tucking was done, and Group II comprised of 50 patients in which circumferential flap tympanoplasty was done. Improvement in the hearing gain and graft uptake success rate was compared. Results: The mean air-bone gap (ABG) changed from 28.74 dB to 11.52 dB after anterior tucking with a mean change of 17.22 dB and this change was found to be statistically significant (p<0.001). Similarly, the mean ABG changed from 28.92 dB to 11.86 dB after a circumferential flap with a mean change of 17.06 dB and this change was also found to be statistically significant (p<0.001). There was a slightly better improvement (17.22 dB) in the anterior tucking group as compared to the circumferential flap (17.06 dB). This difference was, however, not found to be statistically significant (p=0.830). Three-month graft uptake rate in the anterior tucking group was found 92% and in the circumferential group was 94%. (p>0.05). Conclusions: Our study concluded that both techniques have almost the same results with good graft uptake. Results of hearing improvements in both techniques were also comparable.
Highlights
Tympanoplasty is a surgical process that removes the infection from the middle ear, makes it dry, and restores middle ear function in patients with chronic otitis media
100 patients with chronic otitis media were enrolled, who were randomly allocated in two groups; Group 1 which comprised of 50 patients in which tympanoplasty with anterior tucking was done, Group 2 comprised of 50 patients in which circumferential flap tympanoplasty was done
The mean air-bone gap (ABG) in Fig.1, changed from 28.74 dB to 11.52 dB after anterior tucking with a mean change of 17.22 dB and this change was found to be statistically significant (p
Summary
Tympanoplasty is a surgical process that removes the infection from the middle ear, makes it dry, and restores middle ear function in patients with chronic otitis media. Robert et al examined the risk factors of re-perforation following tympanoplasty They found that surgical technique was the more effective factor in the final results based on statistical analysis. Due to the acute angle between the TM and the anterior canal wall, the underlay technique is less favorable in subtotal perforation, as it includes lack of graft support and less vascularity, with a greater risk of reperforation [1]. To improve the hearing gain and graft uptake success rate, we used two modifications of the underlay technique, one was anterior tucking tympanoplasty and the second one was circumferential tympanomeatal flap tympanoplasty. We aimed to compare the success rate of graft uptake and post-operative hearing improvement in circumferential versus anterior tucking underlay tympanoplasty technique in chronic otitis media with an inactive mucosal disease with subtotal perforation
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