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Otol Neurotol. 2010 Jul;31(5):773-5. doi: 10.1097/MAO.0b013e3181e40a41.

Comparison between transtympanic and elevation of tympanomeatal flap approaches in tympanoplasty.

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  • 1Division of Otorhinolaryngology, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. firasz@just.edu.jo

Abstract

OBJECTIVE:

Transtympanic tympanoplasty is an easy way of introducing a graft through the tympanic membrane to repair a perforation. The aim of our study is to compare the transtympanic technique with the usual method of elevating a tympanomeatal flap.

STUDY DESIGN:

Prospective randomized trial.

SETTING:

Tertiary referral teaching hospital.

PATIENTS:

Patients undergoing surgery for tympanic membrane perforations by the ENT team of King Abdullah University hospital between April 2004 and June 2009.

INTERVENTIONS:

Surgery.

MAIN OUTCOME MEASURES:

Perforations were stratified according to their sizes. Hearing was assessed preoperatively and postoperatively. The success rates defined as perforation closure and hearing improvement were compared between the 2 groups.

RESULTS:

A total number of 61 patients were enrolled in this study; 29 patients underwent the transtympanic approach, and 32 patients had a tympanomeatal flap elevated under general anesthesia. There was no statistical difference in the success rate between the 2 groups for all perforation sizes, although the tympanomeatal flap elevation technique was more effective in large perforations. There was a statistically significant average of 9 minutes saved in the transtympanic approach. There was a significant advantage in hearing improvement at 1 kHz favoring the transtympanic method.

CONCLUSION:

Transtympanic tympanoplasty is a simple technique with comparable success rate to the tympanomeatal flap technique in tympanic membrane closure and hearing results. We recommend it for small- and medium-sized perforations.

PMID:
20502373
DOI:
10.1097/MAO.0b013e3181e40a41
[PubMed - indexed for MEDLINE]
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