The role of anterior tucking of graft in subtotal perforation of tympanic membrane

Abstract

<p class="abstract"><strong>Background:</strong> Tympnaoplasty has been well accepted as the surgery of choice for chronic otitis media. Since the introduction of tympanoplasty, there has been many modifications in terms of technique, approach, and materials used for grafting the tympanic membrane; each with their respective advantages and disadvantages. But irrespective of procedure done, very large and subtotal perforations have always posed a problem with failure after surgery. This demands further modification of the procedure to support the graft. This study was done to know the role of Anterior tucking of graft in subtotal perforation of tympanic membrane in terms of graft uptake rate and hearing outcome.</p><p class="abstract"><strong>Methods:</strong> A systemic retrospective analysis of case files was done. The case files of patient who fulfilled the inclusion criteria were selected. Detailed preoperative and postoperative clinical and audiometric findings were noted down.  </p><p class="abstract"><strong>Results:</strong> Total of 40 cases with 3 cases being bilateral, 43 ears were operated by cortical mastoidectomy with tympanoplasty along with anterior tucking of the graft. Our success rate was 95.3% (n=40). 40 patients had showed the improvement in hearing with average air bone gap gain of 12.7 dB HL.</p><p class="abstract"><strong>Conclusions:</strong> Underlay grafting for subtotal perforations of tympanic membrane is a surgically challenging and results in poor outcome. Modification to this method by anterior tucking of the graft is an effective surgical technique with satisfactory outcomes and hence is advocated for the routine practice.</p>