Meatotympanoplasty with Special Reference to the Postoperative Hearing

Abstract

We introduce our experience in “meatotympanoplasty”, a tympanoplastic operation with the preservation of the ear canal. The outline of the procedure is elevation of the skin of the ear canal from the bony wall as a pedicule tube, retrograde removal of the bridge portion as needed, excentration of the mastoid pathology by retroauricular approach, re-establishment of middle ear conductive system, covering the ossicles with the connective tissue flap, and repositioning the skin of ear canal over the flap. Postoperative drying of the ear canal is attained early and the after care is unnecessary. It is also emphasized that the preservation of the normal ear canal is the method of choice from the standpoint of hearing gain. A favorable effect of the preservation of the normal ear canal upon the postoperative hearing was substantiated by clinical and experimental studies. Clinically, the hearing was compared before and after packing the posterior fossa of the tympanoplastically operated ear canal. Experimentally, the effect of the posterior fossa upon the resonance of ear canal was studied using a plaster ear model and dissected human temporal bones. These experiments confirmed that the normally constructed ear canal improved the hearing in higher frequencies by about 20 dB in comparison with that in the presence of posterior fossa.