Effect of Canalplasty on Outcome of Results in Type I Tympanoplasty
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Abstract
Background: The aim of the surgical procedure of tympanoplasty is to strive to achieve an intact neo tympanum with normal hearing acuity. Widening of the external auditory canal, called canalplasty, helps in better visualization and hence better placement of the tympanic membrane graft. Aim of this study was to compare effect of canalplasty on the outcome of results of type I tympanoplasty.
Methods: 50 cases of patients diagnosed with chronic otitis media mucosal disease with a central dry perforation involving two or more quadrants of the tympanic membrane were included in the study. One group of 25 cases underwent tympanoplasty with canalplasty and was grouped under Group I while the other group of 25 cases underwent tympanoplasty without canalplasty and was called group II.
Results: Analysis was done for graft uptake, hearing improvement and time taken for the surgery. Group I achieved a success rate of 92% graft uptake as compared to group II, which achieved 84%. There was statistically significant improvement in post-operative hearing in cases with canalplasty. Time taken was between the two groups were not statistically significant.
Conclusion: Anatomical and technical factors diversely affect the functional outcome of tympanoplasties. Canalplasty helps in better visualization and placement of the graft. Time spent on drilling in canalplasty is compensated by the time gained in grafting of the neo tympanum. The procedure prevents lateralization of the graft due to the accurate exposure of the annulus. Post operative care is also easier in cases of tympanoplasty with canalplasty.
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References
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Khan I, Jan AM, Shahzad F. Middle-ear reconstruction: a review of 150 cases. J Laryngol Otol. 2002;116(6):435–9.
Roychaudhuri BK. 3‑flap tympanoplasty – A simple and sure success technique. Indian J Otolaryngol Head Neck Surg 2004;56:196‑200.
Wasson JD, Papadimitriou CE, Pau H. Myringoplasty: impact of perforation size on closure and audiological improvement. J Laryngol Otol. 2009;123(9):973–7.
Livingstone G, Millar H. Results of tympanoplasties, 1956-1959. J Laryngol Otol 1961;75:669-78.
Wang WH, Lin YC. Minimally invasive inlay and underlay tympanoplasty. Am J Otolaryngol. 2008;29(6):363–366.
Collins WO, Telischi FF, Balkany TJ, Buchman CA. Pediatric tympanoplasty – effect of contralateral ear status on outcomes. Arch Otolaryngol Head Neck Surg. 2003;129: 646-51.
Vijendra H, Ittop CJ, Sangeetha R. Comparitive study of hearing improvement in type I tympanoplasty with and without canalplasty. Indian J of Otolaryngol. Head and Neck Surg. 208; 60(4):341-4.
MK Taneja MK. Role of canaloplasty. Ind J of Otology. 2013; 19(4) :159-63.
Lavy J, Fagan P. Canalplasty: review of 100 cases. J Laryngol Otol. 2001; 115(4):270-3.
Sismanis A. Tympanoplasty. In: Glascock ME 3rd editor. Glsscock- Shambaugh Surgery of the Ear. 5th ed. Hamilton, Ontario: Decker BC, WB Saunders Company; 2003. p. 463-484.
McGrew BM, Jackson G. Impact of mastoidectomy on simple tympanic membrane perforation repairs. Laryngoscope. 2004;114:506–511.
Webb BD, Chang CY. Efficacy of tympanoplasty without mastoidectomy for chronic suppurative otitis media. Arch Otolaryngol Head Neck Surg. 2008;134(11):1155–1158.
Prasad KC, Hegde MC, Prasad SC, Meyappan H. Assessment of eustahian tube function in tympanoplasty. Otolaryngol Head Neck Surg. 2009;140(6):889–893.
Boronat-Echeverría NE, Reyes-García E, Sevilla-Delgado Y, Aguirre-Mar¬iscal H, Mejía-Aranguré JM. Prognostic factors of successful tympano¬plasty in pediatric patients: a cohort study. BMC Pediatr 2012; 12; 12: 67.
Bhat NA, De R. Retrospective analysis of surgical outcome, symptom changes, and hearing improvement following myringoplasty. J Otolar¬yngol 2000; 29: 229-32.
Adkins WY, White B. Type I tympanoplasty: influencing factors.Laryngoscope. 1984;94(7):916–918.
Khan I, Jan AM, Shahzad F. Middle-ear reconstruction: a review of 150 cases. J Laryngol Otol. 2002;116(6):435–439.
Roychaudhuri BK. 3‑flap tympanoplasty – A simple and sure success technique. Indian J Otolaryngol Head Neck Surg 2004;56:196‑200.
Wasson JD, Papadimitriou CE, Pau H. Myringoplasty: impact of perforation size on closure and audiological improvement. J Laryngol Otol. 2009;123(9):973–977.
Livingstone G, Millar H. Results of tympanoplasties, 1956-1959. J Laryngol Otol 1961;75:669-78.
Wang WH, Lin YC. Minimally invasive inlay and underlay tympanoplasty. Am J Otolaryngol. 2008;29(6):363–366.
Collins WO, Telischi FF, Balkany TJ, Buchman CA. Pediatric tympanoplasty – effect of contralateral ear status on outcomes. Arch Otolaryngo l Head Neck Surg. 2003;129: 646-651.
Vijendra H, Ittop CJ, Sangeetha R. Comparitive study of hearing improvement in type 1 tympanoplasty with and without canalplasty. Indian J of Otolaryngol. Head and Neck Surg. 208;60(4):341-344.
MK Taneja MK. Role of canaloplasty. Ind J of Otology. 2013;19(4) : 159-163.
Lavy J, Fagan P Canalplasty: review of 100 cases. J Laryngol Otol. 2001 ;115(4):270-3.