Comparison of canal wall incisions for tympanoplasty for large central perforations

Vadiya, Sohil; Shah, Saumya K; Chaudhary, Mamta

doi:10.4103/0971-7749.159709

Cited by 7 publications

(6 citation statements)

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“…For all the cases in both groups, postauricular incision was used. Vascular strip incision with anterior tucking (VSAT) technique of canal wall incision [ 4 ] was used in all cases in both groups. Temporalis fascia graft was harvested and, after canal wall incisions, middle ear was explored after lifting the annulus and intactness of all ossicles was confirmed.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Modified Cartilage Shield Tympanoplasty with Tympanoplasty Using Temporalis Fascia Only: Retrospective Analysis of 142 Cases

et al. 2016

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The current study compares outcomes of modified cartilage shield tympanoplasty (CST) with temporalis fascia tympanoplasty in type I procedures in Indian patients. Graft uptake rates are better with the CST technique and hearing results are almost equivalent with both techniques except at 8000 Hz where improvement in hearing was found better with the use of temporalis fascia alone. The CST technique used in the study is unique.

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Section: Methodsmentioning

confidence: 99%

Comparison of Modified Cartilage Shield Tympanoplasty with Tympanoplasty Using Temporalis Fascia Only: Retrospective Analysis of 142 Cases

et al. 2016

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“…13,14 Mokhtarinajad et al, Mishra et al, Guneri et al, Singh et al and Potsic et al did circumferential sub annular grafting with lateral placement of graft. 5,[16][17][18][19] Pradhan et al elevated circumferential tympanomeatal flap and compared outcomes between underlay and overlay technique. 3 We preferred circumferential elevation of tympanomeatal flap with underlay technique of graft placement.…”

Section: Resultsmentioning

confidence: 99%

“…It is very important to provide support to the graft material by additional canal incisions for large central perforations, in order to avoid any residual perforations and medialisation. 5 Classically described vascular strip technique has some limitations with respect to anterior and large or subtotal perforations. Circumferential elevation of tympanomeatal flap and underlay graft placement is thought to be a good surgical technique as it ensures elevation of canal skin over the Eustachian tube area to form a good assemble between the temporalis graft and the flap to increase the success rate, but elevation of tympanic annulus over anterior superior quadrant can lead to blunting of the tympanomeatal angle resulting in conductive hearing loss.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of circumferential tympanomeatal flap tympanoplasty in large central perforation

Venkatesha

Yogeesha

khan

2018

Int J Otorhinolaryngol Head Neck Surg

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Background: Tympanoplasty is the commonest procedure performed in patients with chronic otitis media. Circumferential elevation of tympanomeatal flap and underlay graft placement is thought to be a good surgical technique as it ensures elevation of canal skin over the Eustachian tube area to form a good assemble between the temporalis graft and the flap to increase the success rate. In our study we intend to study the surgical and hearing outcome in patients undergoing tympanoplasty with circumferential tympanomeatal flap in large central perforations.Methods: A prospective study with 25 patients in a tertiary care hospital for a period of 2 years, who underwent circumferential tympanomeatal flap tympanoplasty. Patients were followed up on one month and two months. Graft outcomes and hearing outcomes were studied. Results: Graft uptake was 92%. Blunting was noticed in 4% and medialisation in 4% of patients in circumferential group. Average air-bone gap closure achieved was 17.468 dB.Conclusions: Circumferential flap elevation in tympanoplasty is an effective surgical technique in patients with anterior and large central perforations with satisfactory outcomes.

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“…Surgical technique -After infiltration with 2% lidocaine with 1:200,000 adrenaline, all patients were operated through a post aural approach (Wilde's incision) by the same set of surgeons to gain surgical access after elevating a prior vascular strip end aurally. 3 After elevation of tympanomeatal flap and freshening of the margin, ossicular mobility and continuity were checked. In cases of an intact and mobile ossicular assembly and no evidence of squamous disease, patients were subjected to randomization to either the underlay tympanoplasty with anterior tunnelling (ut+T) or the conventional tympanoplasty group with anterior tucking (ut+at) by allocating sequentially.…”

Section: Methodsmentioning

confidence: 99%

Does Anterior Tunnelling Really Help in Underlay Type I Tympanoplasty?

Kundu

Ghosh

Adhikary

et al. 2017

BJOHNS

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Introduction Stabilizing the graft can be difficult with the conventional method of underlay tympanoplasty when the tympanic membrane perforation is subtotal, large or anteriorly placed with thin anterior rim. Tympanoplasty with anterior tunnelling has been tried to overcome this problem. Materials and Methods A prospective study over two-year period was carried out with follow up for three months on 59 patients under two groups- the underlay tympanoplasty with anterior tunnelling and the conventional tympanoplasty with anterior tucking for comparison in terms of pre-and post-operative anatomical correction and physiological improvements Results Follow up at 6 weeks and 12 weeks post operatively gives statistically comparable graft take up, hearing result and residual perforations. Discussion Among various techniques of dealing with these types of perforations, statistical comparability of the two groups brings in an acceptability to this simple but satisfying procedure of the underlay tympanoplasty with anterior tunnelling. Conclusion Underlay tympanoplasty technique (type-I) for subtotal, large or anteriorly placed perforations with thin anterior rim, can be managed by combining with anterior tunnelling which provides at least comparable results (if not more security against graft medialization) in respect of anatomical closure of perforations and hearing outcomes.

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Comparison of canal wall incisions for tympanoplasty for large central perforations

Cited by 7 publications

References 0 publications

Comparison of Modified Cartilage Shield Tympanoplasty with Tympanoplasty Using Temporalis Fascia Only: Retrospective Analysis of 142 Cases

Comparison of Modified Cartilage Shield Tympanoplasty with Tympanoplasty Using Temporalis Fascia Only: Retrospective Analysis of 142 Cases

Outcomes of circumferential tympanomeatal flap tympanoplasty in large central perforation

Does Anterior Tunnelling Really Help in Underlay Type I Tympanoplasty?

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