Transcanal endoscopic type I tympanoplasty effective in tympanic membrane perforation cases
Chronic suppurative otitis media (CSOM) induced tympanic membrane perforation (TMP) can be accompanied by anterior mallear ligament (AML) calcification. So far, comparative evaluations of tympanic membrane perforation with and without anterior mallear ligament calcification have rarely been reported.
The tympanic membrane perforation with anterior mallear ligament calcification leads to higher air–bone gaps at low frequencies. The hearing outcomes are similar for tympanic membrane perforation both with and without anterior mallear ligament calcification after surgery, explains Cong Wu and associates from the Department of Otorhinolaryngology–Head and Neck Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
The study is published in the Ear, Nose and Throat Journal.
The authors compared the hearing outcomes of tympanic membrane perforation with and without calcification of anterior mallear ligament under transcanal endoscopic type I tympanoplasty.
The records of 67 patients diagnosed with chronic suppurative otitis media and receiving transcanal endoscopic type I tympanoplasty were divided into the anterior mallear ligament calcification group (Cal group, n = 31) and the non- anterior mallear ligament calcification group (non-Cal group, n = 36).
The 31 patients in the Cal group were divided into subgroup A and B according to the severity of calcification. The operation time, closure rate, and pre- and postoperative audiometric results were retrospectively collected and analyzed.
It was observed that preoperatively, the Cal group had higher mean air–bone gap (ABG; P = .022), and air–bone gaps at 250 Hz (P = .017) and 500 Hz (P = .008) compared with the non-Cal groups. Also, the Cal group showed higher improvements of air–bone gaps at 250 Hz (P = .039) and 500 Hz (P = .021) compared with the non-Cal groups postoperatively.
Therefore, it was concluded that transcanal endoscopic type I tympanoplasty is an appropriate surgical method for tympanic membrane perforation with anterior mallear ligament calcification, if the lesion can be detected and completely eliminated.