Anterior transcanal tympanoplasty: A novel technique to repair anterior perforations

OBJECTIVE: To report a novel, minimally invasive technique for anterior tympanic membrane (TM) perforation repair. STUDY DESIGN: A transcanal repair of the anterior TM was performed on 45 patients. METHODS: A total of 689 patients with chronic suppurative otitis media underwent surgical intervention; of these, 45 patients with isolated anterior TM perforations underwent an anterior tympanoplasty. This approach is similar to a transcanal approach for small posterior perforations; an anterior rather than a posterior flap is raised. RESULTS: Perforations ranged from 20 to 50 percent in size. Preoperative air-bone gaps ranged from 5 to 51 dB and averaged 25 dB. Postoperative air-bone gaps ranged from 0 to 33 dB and averaged 14 dB. Of 45 patients, 40 (88%) had closure of their perforations. Data from 1- to 10-year follow-up are provided. CONCLUSIONS: The anterior transcanal tympanoplasty is a minimally invasive technique to repair anterior TM perforations. The procedure is simple and obviates the need for a large postauricular incision. (C) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.