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Updated: Mar 15, 2026

The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Postoperative Pain Following a Retroauricular Approach Versus a Transcanal Approach in Tympanoplasty Type 1: A 14-Day
Wen-Ching Chuang1, Li-Chun Hsieh2,3,4, Chin-Kuo Chen1,5,6
1Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
Abstract:
Objectives: This study aimed to determine whether the surgical approach used significantly affected postoperative pain and quality of life. Methods: This retrospective study included 45 adult patients undergoing type I tympanoplasty for chronic tympanic membrane perforation. The patients were divided into two groups: transcanal (n = 24) and retroauricular (n = 21). Postoperative pain was assessed using the Wong-Baker FACES® Pain Rating Scale. Additional outcomes included analgesic use and activity limitation. Results: The graft success rates in the transcanal and retroauricular groups were 95.8% and 95.2%, respectively. The transcanal group reported significantly lower pain scores between postoperative days 5 and 8 (p < 0.05) and discontinued analgesic use earlier (mean 3.1 versus 4.3 days; p < 0.05). Furthermore, the transcanal group had fewer activity limitation events during recovery. Operative time was significantly shorter in the transcanal group (55.4 ± 10.1 versus 90.2 ± 10.6 min; p < 0.001). No major complications were observed in either group. Conclusions: A transcanal approach is associated with reduced postoperative pain, earlier recovery, and shorter analgesic use than a retroauricular approach in tympanoplasty type I.

