Comparison of Tympanoplasty Done with Removal of Posterior Canal Wall Skin versus Tympanoplasty Done with Preservation of Canal Wall Skin

Aims and Objectives: The aim of this study is to compare the outcomes of type 1 tympanoplasty in terms of graft uptake, hearing improvement, operative time, and healing time in patients operated with posterior canal skin preservation or without it. Materials and Methods: This is a prospective study of 100 patients operated for type 1 tympanoplasty surgery at a tertiary care hospital from August 2021 to June 2023 and operated by a single surgeon. Patients were divided into two groups and were randomly allocated (one with posterior canal skin preservation and other without it). Inclusion criteria were all patients operated for tympanoplasty between 12 and 50 years of age. Exclusion criteria were patients with mixed hearing loss or sensorineural hearing loss and patients who had to undergo ossicular chain reconstruction and revision cases were also excluded from the study. The outcomes were evaluated on follow-up by otoendoscopy and pure-tone audiometry. Observation and Discussion: In terms of graft uptake at 3-month postoperative period, no significant difference was found between both the groups. In terms of hearing improvement and healing time, P > 0.1 was noted, and hence the difference was not significant. However, the operative time was significantly lower for the group with posterior canal wall skin removal. Conclusion: Removal of skin from posterior surface of external auditory canal improves visualization during tympanoplasty. It reduces operative time and provides same success rates in terms of graft uptake and hearing improvement. It has almost the same healing time, and granulations or other canal-related complications are minimal. Graft medialization or lateralization is also minimal when anterior tucking and lateral tucking of graft is done.