Abstract
Background and Objective: Chronic otitis media is an inflammatory process of the middle ear that is accompanied by irreversible pathologic changes and almost invariably is accompanied by tympanic membrane perforation. One of the basic principles of middle ear surgery for patients with chronic otitis media is reconstruction of the tympanic membrane for closure of the middle ear and reestablishment of sound transfer mechanism. Keeping in mind that anterior and subtotal tympanic membrane perforations have higher failure rate following reconstructive procedures, if we try to decrease the failure rate of reconstructive methods of these types perforations, this will affect the final outcome of chronic otitis media management positively. The aim of this study was comparison of two different techniques in reconstruction of anterior tympanic membrane perforations.
Materials and Methods: In a case-control clinical trial over a 2 year period, between April 2004 and April 2006 in Tabriz Imam Khomeini Hospital, 60 patients with chronic otisis media having anterior tympanic perforations underwent tympanoplastic surgery. Thirty of the patients were operated by placing the temporal fascia graft under the anterior remnants of the tympanic membrane. In thirty others an incision was made in the anterior skin of the external ear canal lateral to the annulus creating an anterior flap, and the anterior edge of the temporal fascia graft was pulled beneath the annulus and entrapped under the anterior flap.
Results: The average age in the entrapment group was 34.5 years old and in the group without entrapment was 34.3 years old and overall average age was 34.4 years old, 60% were female and 40% were male. There were 3 failures (90% success rate) in the group with entrapping and 5 failures (83.4% success rate) in the group without entrapping the graft
(P= 0.448).
Conclusion: Our main hypothesis was that there was a meaningful statistical difference between the success rates of the two techniques. After analyzing the findings we concluded that in spite of a few more cases of successfully reconstructed tympanic membrane with the entrapping technique, there was no meaningful statistical difference between the success rates of the two groups. So according to these data, the entrapping technique is not proposed as a routine method in approaching to anterior tympanic perforations.