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Document Type

Original Article

Abstract

Introduction: When the perforation in the tympanic membrane is anteriorly located with a thin anterior rim, stabilizing the graft using the traditional underlay tympanoplasty approach may be challenging. It was attempted to solve this issue using tympanoplasty with anterior tunneling or anterior releasing. Aim and Objectives: This study aims to compare the efficiency of anterior tunnel and anterior release techniques in the management of anterior tympanic membrane perforation. Patients and Methods: A one-year prospective single blinded study with three-months follow-up was conducted on 60 patients divided into two groups: tympanoplasty with tunneling (Group A) and release (Group B) tympanoplasty for comparison in regards to before and after surgery anatomical correction and physiological enhancements. Results: The average (ABG) in (Group B) decreased from 22.2 dB to 10.6 decibels, with an average drop of 11.6 dB. Similarly, the average change in (Group A) of 9.6 dB from 18.6 dB to 9.3 dB. ABG improved in both groups, with the release group improving slightly more compared to the anterior tunnel group. (Group A) three-month graft uptake rate has been reported to be 93.3%, whereas (Group B) was 96.6% (p=0.7). Conclusion: For anteriorly located perforations with a thin anterior rim, tympanoplasty technique (type-I) may be combined with anterior tunneling or anterior release. Our research showed that the outcomes of both procedures were nearly the same, with good graft uptake in the release group. Hearing enhancement outcomes in both approaches were equivalent, with the release technique producing a good result.

Keywords

Anterior Tympanic membrane perforation; Anterior Tunnel; Anterior Release

Subject Area

ENT

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