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Microscopic Over-under Versus Medial Tympanoplasty for Larger Tympanic Membrane Perforations
Xiaowen Zhang1, Caili Ji1, Aifeng Li1
1Department of Otorhinolaryngology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Objectives:
To identify the differences in hearing, anatomical success rate, functional success rate, and complications between over-under tympanoplasty and medial tympanoplasty procedures.
Methods:
The clinical data of patients with tympanic membrane perforation repaired by medial tympanoplasty between January 2011 and December 2016 and by over-under tympanoplasty between January 2017 and December 2020 were retrospectively analyzed. We evaluated the differences between medial tympanoplasty and over-under tympanoplasty.
Results:
The overall success rate of over-under tympanoplasty was higher than that of medial tympanoplasty (90.76% vs 81.31%). In large perforations, the success rate of over-under tympanoplasty was higher than that of medial tympanoplasty (89.80% vs 71.43%). There was no statistically significant difference in the success rate between the two treatment groups for moderate perforations. Furthermore, there was no statistically significant difference in the incidence of complications between the two groups (P = .2637).
Conclusions:
Over-under tympanoplasty is more suitable for large perforations of the tympanic membrane and has a higher success rate as compared to medial tympanoplasty.
Insights
Over-under tympanoplasty shows a higher success rate, especially for large tympanic membrane perforations, compared to medial tympanoplasty. Complication rates were similar between the two surgical techniques.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Auditory Health
Background:
- Tympanic membrane perforation is a common condition requiring surgical repair.
- Medial tympanoplasty has been a standard technique for decades.
- Advancements in surgical techniques aim to improve outcomes for tympanic membrane repair.
Purpose of the Study:
- To compare the efficacy and safety of over-under tympanoplasty versus medial tympanoplasty.
- To evaluate differences in hearing outcomes, anatomical success, functional success, and complications.
- To determine the optimal technique for different perforation sizes.
Main Methods:
- Retrospective analysis of clinical data from patients undergoing tympanoplasty.
- Comparison of medial tympanoplasty (2011-2016) with over-under tympanoplasty (2017-2020).
- Evaluation of success rates and complication incidence for both procedures.
Main Results:
- Over-under tympanoplasty demonstrated a higher overall success rate (90.76%) than medial tympanoplasty (81.31%).
- For large perforations, over-under tympanoplasty had a significantly higher success rate (89.80%) versus medial tympanoplasty (71.43%).
- No significant difference in success rates for moderate perforations or complication incidence between the groups.
Conclusions:
- Over-under tympanoplasty is a more effective technique for large tympanic membrane perforations.
- The over-under approach offers improved success rates compared to medial tympanoplasty.
- Both techniques exhibit comparable safety profiles regarding complications.
