The window shade technique of tympanic membrane grafting

“Window Shade” Tympanoplasty for Anterior Marginal Perforations

“…In the early 1970s, problems with slow healing, granulation formation, and perforations with meatal skin grafts prompted Calcaterra 6 to devise the window shade technique. His procedure elevated the epithelium off the tympanic membrane in continuity with the canal skin and rolled the flap laterally.…”

“…He found that recurrent anterior perforations were minimized because the flaps preserved the vascular supply, especially anteriorly, to the graft. In addition, granulation and infection were rarely encountered, and he reported no episodes of anterior blunting 6 …”

“…For anterior perforations, techniques by Calcaterra 6 and Primrose and Kerr 7 have been described. Calcaterra first described the “window shade” technique in 1972.…”

Efficacy of “hammock” tympanoplasty in the treatment of anterior perforations

“…Reasons for poor surgical outcome include reduced vascular supply, limited anterior margin, poor visualization, and inadequate graft stabilization . A variety of surgical techniques have been developed to increase surgical success in treating anterior perforations, including sandwich graft tympanoplasty, over‐under tympanoplasty, mediolateral graft tympanoplasty, “anterior hitch” technique, and “window shade” technique . These techniques either attempt to secure the graft anteriorly via retrograde elevation of the anterior annulus (e.g., anterior hitch technique and window shade technique), or combine medial graft (for the posterior perforation) with lateral graft for the anterior perforation (e.g., over‐under tympanoplasty and mediolateral graft tympanoplasty).…”

The Anterior Interlay Myringoplasty

“…The window shade technique (25) is also described as giving excellent access and results for anterior perforations. It was initially described in 1972 (25) and its application for marginal and anterior perforations presented in 2005 (26).…”