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abstract nr.: O100
EXTENDED TYMPANOMEATAL FLAP (ETMF) TYMPANOPLASTY FOR TOTAL OR SUBTOTAL PERFORATIONS OF THE TYMPANIC MEMBRANE
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Author:
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N.B. Prahlada, Karnataka ENT Institute & Research Centr, Chitradurga, India |
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Co-author(s):
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Topic:
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Surgery |
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Keywords:
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Underlay technique, Tympanoplasty, Total/Subtotal Perforation, Extended tympanomeatal falp |
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OBJECTIVES : Various techniques of tympanoplasty used today to reconstruct the tympanic membrane (TM) with total/subtotal perforations are associated with risk of anterior blunting, neotympanum lateralization and recurrent perfortions. An Extended tympanomeatal flap (ETMF) tympnoplasty technique for reconstruction of the TM with total/subtotal perforations to overcome above problems is presented here.
METHOD : 47 patients with total/subtotal perforation of the TM were included in this Randomized Prospective Study. Inferiorly based ETMF was used. Canalplasty done. Large temporalis fascia was grafted by underlay technique, placed medial to the malleus by making a slit, in such a way that is lies all around the bony canal except in inferior region where it is tucked into the hypotympanum.
RESULTS : Mean follow up is 2.1 years. No residual perforation occurred in all cases. The hearing results were same as in other techniques.
CONCLUSIONS : This technique is a valuable method for the closure of total/subtotal perforations of the TM. It eliminates the need for an anterior window and if need arises, atticotomy or atticoantrostomy can be done without disturbing the skin flaps. The skin flaps and large area of bone contact, not only ensure the stability of the graft, but also provides for blood supply. The hearing results are comparable to that achieved in other techniques. Further studies are required to assess long term results.
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Presentation preference:
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