Type I tympanoplasty with total annular excision; A single center prospective study

Abstract

Introduction: CSOM (mucosal type) is characterized by the presence of tympanic membrane perforation with episodic ear discharge associated with URTI and associated conductive hearing loss. Such a condition is addressed surgically by tympanoplasty.
Aims: We aimed to study results of type I Tympanoplasty with Total Annular excision in mucosal type of CSOM. Materials and methods: Patients in this study ( n= 20) had a central perforation of Tympanic membrane with history of intermittent episodes of ear discharge & hardness of hearing. Pre operative assessment with otoendoscopy done to rule out squamosal pattern of CSOM and hearing assessment was done to rule out SNHL. Routine steps of underlay technique of tympanoplasty were performed except for complete removal of Tympanic membrane with fibrous annulus was performed and grafting with temporalis fascia was done by placing the graft under handle of malleus and edges (360°) placed under EAC skin close to bony annulus. Routine post operative care given and patients followed up for a period of one year. Results : 18 out of 20 cases showed definitive graft uptake and improvement in conductive hearing loss. Conclusion : This technique allowed prevention of post op Mucosalisation which was not uncommon in post operative ears after tympanoplasty.