Modified House tympanoplasty for successful closure of near-total tympanic membrane perforations

Objective: To demonstrate the use of a modified House technique in the successful closure of near-total tympanic membrane perforations. Methods: This is a retrospective analysis over a 25-year span of the senior author's experience with a particular technique of closing large tympanic membrane perforations. The charts of patients were reviewed and the data were analyzed. Technique: The modified House technique combines an underlay graft placement with an advancement car canal skin flap. It provides vascularization and subsequent early epithelialization of a large perforation. Results: In this series, the senior author operated on 46 patients. Forty-three patients had one car operated on and three had bilateral surgery. The closure rate was 98% (48 of 49 ears). The one failure had a subsequent successful closure at a later date. Conclusion: This is a simple endaural technique that guarantees successful closure of near-total tympanic membrane perforations using locally available tragal perichondrium.