Anterior Tucking Tympanoplasty Technique in Inactive Mucosal Chronic Otitis Media with Subtotal Perforations

The present study aimed to compare the success rate of graft uptake and post-operative hearing improvement in circumferential versus anterior tucking underlay tympanoplasty technique in chronic otitis media with an inactive mucosal disease with subtotal perforation.

Tympanoplasty or myringoplasty is one of the most commonly Performed procedures by otologists. With advancement in the field of Otology. This hospital-based prospective observational study was conducted for a period of 1 year from December 2017 to November 2018. In this prospective observational study, 100 patients with chronic otitis media (Inactive mucosal type) were included, who were randomly allocated in two groups; Group I which comprised of 50 patients in which tympanoplasty with anterior tucking was done, and Group II comprised of 50 patients in which circumferential flap tympanoplasty was done. Improvement in the hearing gain and graft uptake success rate was compared.

The mean air-bone gap (ABG) changed from 28.74 dB to 11.52 dB after anterior tucking with a mean change of 17.22 dB and this change was found to be statistically significant (p<0.001). Similarly, the mean ABG changed from 28.92 dB to 11.86 dB after a circumferential flap with a mean change of 17.06 dB and this change was also found to be statistically significant (p<0.001). There was a slightly better improvement (17.22 dB) in the anterior tucking group as compared to the circumferential flap (17.06 dB). This difference was, however, not found to be statistically significant (p=0.830). Three-month graft uptake rate in the anterior tucking group was found 92% and in the circumferential group was 94%. (p>0.05).

Our study concluded that both techniques have almost the same results with good graft uptake. Results of hearing improvements in both techniques were also comparable. Due to graft lateralization and anterior blunting, subtotal perforations are more likely to fail after underlay technique.