Publication:

Comparative study of outcomes of type 1 tympanoplasty with and without anterior tucking

Background Type-1 tympanoplasty is the functional restoration of the normal middle ear by repairing the tympanic membrane (TM). Different techniques are still evolving to devise a way to give optimal graft uptake and hearing improvement with minimal instrumentation. Various studies have been done to assess the role of anterior tucking in type-1 tympanoplasty and to assess its superiority over other methods in repairing subtotal perforations and large perforations involving the anterior quadrant.

Methods This study was done to compare the outcomes of endoscopic type-1 tympanoplasty with and without anterior tucking. 60 cases of chronic otitis media (COM) mucosal type were divided into 2 groups of 30 patients each. Group 1 underwent endoscopic type-1 tympanoplasty with anterior tucking and group 2 underwent endoscopic type-1 tympanoplasty without anterior tucking. The outcomes were evaluated after 6 months and compared in terms of graft uptake and hearing gain.

Results The mean air-bone gap improvement was 13.16±2.65 in group 1 and 12.90±3.78 in group 2, which had statistically insignificant differences indicating similar hearing outcomes in both the groups. 96.7% successful graft uptake was achieved in group 1 and 90% in group 2, showing statistically insignificant differences indicating similar graft uptake rates in both the groups.

Conclusions Anterior tucking with endoscopic type-1 tympanoplasty could provide good graft support and efficient hearing improvement but cannot be labelled as a mandatory step in repairing subtotal perforations or large perforations involving anterior quadrant as the outcomes are comparable to the endoscopic type-1 tympanoplasty done without anterior tucking.