Anterosuperior anchoring myringoplasty technique for anterior and subtotal perforations

Anterior and subtotal tympanic perforations are difficult perforations to repair. We used the anterosuperior anchoring technique to repair 105 of those perforations. Our technique utilizes a large temporalis fascia graft using an underlay technique with due emphasis on anterosuperior anchorage. The success rates in paediatric myringoplasty for consultant solo (J.R.K.) and trainees under supervision were 100% and 85.7%, respectively. The overall success rates in adult myringoplasty for consultant solo and trainees under supervision were 93.8% and 82.4%, respectively. Analysis of the 82 successful cases showed statistically significant improvement in air conduction thresholds after myringoplasty at 500 Hz (P < 0.01), 1 kHz (P < 0.05), 2 kHz (P < 0.01) and 4 kHz (P < 0.01). Our study showed that the anterosuperior anchoring technique produced excellent results in the repair of challenging anterior and subtotal perforations in both adults and children.