Three-point fix tympanoplasty

Abstract

Conclusion: The three-point fix tympanoplasty procedure is a stable and effective technique – with a high degree of graft take and satisfactory hearing results – for reconstruction of most tympanic membrane (TM) perforations. Objective: It is difficult to repair a TM perforation, including subtotal perforation, involving the anterior part of the annulus. Reperforation can occur when an underlay graft technique is used. An overlay graft technique may result in anterior blunting/lateralization. We introduce a three-point fix tympanoplasty procedure, which can provide additional support to yield a stable graft. Methods: The study enrolled a total of 234 patients who underwent a three-point fix tympanoplasty procedure from November 2005 to June 2011. Anatomic success was defined as an intact, repaired TM, while functional success was defined as a significant decrease in the air–bone gap at the end of follow-up compared with preoperative hearing (air–bone gap). The complication rate was also analyzed. Results: The anatomic success rate was 93.2% (218/234 patients). The functional success rate after an average of 1 year was 73.5%. The postoperative average pure-tone air–bone gap (15.4 ± 11.4 dB) decreased successfully in comparison with the preoperative average air–bone gap (20.6 ± 12.1 dB). There were few postoperative complications (7.7%).

Keywords:

• Tympanic membrane perforation
• fascia
• graft technique
• air–bone gap

Acknowledgments

The authors are grateful to Dong-Su Jang (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Korea) for his help with the figures. The authors would like to express their sincerest gratitude to. The late professor Won-Sang Lee, who is the mentor in our doctor’s life and greatest academic teacher. The development of this technique and the design of this study were conducted by Professor Won-Sang Lee. This study was supported by a grant from the Korea Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A102065).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.