Abstract
Objective Three-flap tympanoplasty, a simple method for tympanic membrane repair, is recorded as an alternative method, which probably has advantages over other procedures and its efficacy evaluated
Patients Four hundred and fifty patients with subtotal or large central perforations with either an anterior bony overhang or vers small anterior rim of the perforation who underwent 3-flap tympanoplasty were included in this study Follow up period was 24 months Technique After removing the margin of the tympanic membrane remnant, three flaps (Superior, anterior and posterior) were elevated from the external auditory canal wall The temporalis fascia graft was then placed over the handle of malleus and all the three flaps were repositioned over the graft
Main outcome measures The graft take over rate and hearing improvement postoperatively were the main outcome measures
Results Four hundred and twenty-five patients (94 44%) had successful grafts Both subjective and objective hearing improvement with a compliant tympanic membrane was seen in all of these patients postoperatively Mediatisation or lateralisation of the intact tympanic membrane did not occur Twenty-five patients had graft rejection, which was noted about 4 weeks after surgery and was due to infections
Conclusion 3-flap tympanoplasty is a simple technique with a very good success rate It is a useful method for busy practioners and junior otolaryngologists
Key Words: 3-flap Tympanoplasty, 3s technique, Tympanomeatal flap, Vascular strip
Full Text
The Full Text of this article is available as a PDF (701.8 KB).
References
- 1.Al-Shaikh A M, Reddy P V, Bizrah M B. Underlay tympanoplasty with anterior and posterior flaps for subtotal perforations. Otolaryngol Pol. 1998;52(2):137–40. [PubMed] [Google Scholar]
- 2.Cvjetkovic N, Velepic M S, Velepic M M, Komljenovic D, Zauhar G. The quantitative analysis of the vascularisation following two basic auditory canal skin incisions. Coll Antropol. 2003;27(1):279–84. [PubMed] [Google Scholar]
- 3.Glasscock M E, Shambaugh G E. Surgery of the Ear. Philadelphia: W B Saunders Company; 1990. pp. 339–343. [Google Scholar]
- 4.Kartush J M, Michaelides E M, Becvarovski Z, LaRouere M J. Over-Under Tympanoplasty Laryngoscope. 2002;112(5):802–7. doi: 10.1097/00005537-200205000-00007. [DOI] [PubMed] [Google Scholar]
- 5.Ludman H, Wright T. Diseases of the ear. Great Britain: Oxford University Press, Inc; 1998. pp. 430–32. [Google Scholar]
- 6.Mills, R P (1997) Scott-Brown’s Otolaryngology, Bath, Reed Educational and Professional Publishing Ltd , 3 10/6
- 7.Shambaugh G E. Surgery of the Ear. London: WB Saunders Company; 1967. pp. 439–444. [Google Scholar]