Is it necessary to retain the tensor tympani tendon in tympanoplasty?
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Updated: Apr 16, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Rui Deng1, Xiong Ou1, Duoduo Tao1
1Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
Objectives/Hypothesis:
To evaluate the acoustic effect after canal wall-down tympanoplasty with sectioning of the tensor tympani muscle (TTM) tendon in patients with chronic otitis media.
Study Design:
Prospective, controlled clinical trial.
Methods:
From January 2010 to April 2014, 212 patients underwent canal wall-down tympanoplasty with ossicular chain reconstruction in one-stage surgery. For this study, the patients were assigned to two groups. In group 1 (107 patients), the TTM tensor would be removed during the surgery, whereas it would be retained in group 2 (105 patients). Pre- and postoperative air conduction and bone conduction thresholds at 0.5, 1, 2, and 4 kHz were reported, and the air-bone gaps (ABGs) were measured.
Results:
Mean postoperative ABG was 16.0 dB in group 1 and 17.0 dB in group 2 and the ABG closure was 11.9 ± 8.5 in group 1 and 11.8 ± 9.7 in group 2. Both were not statistically different (P = .2381 and P = .9625). Overall, 84.1% of patients in group 1 and 75.2% of patients in group 2 attained a postoperative ABG of 20 dB or less. Success rate in group 1 is slightly higher than group 2, but not significant (P = .1255).
Conclusions:
The section of the tensor tympani muscle tendon in canal wall-down tympanoplasty with ossiculoplasty had no statistically significant influence on sound transmission and can be a safe maneuver in middle ear surgery.
Level Of Evidence:
4
