Merits and demerits of transcanal tympanoplasty: an observational study


  • Jyothy O. Kumari Department of ENT, Government Medical College, Ernakulam, Kerala, India
  • Nagendra Mahendra Department of ENT, Yashoda Super Speciality Hospital, Hyderabad, Telangana, India



Chronic suppurative otitis media, Transcanal approach, Tympanoplasty


Background: Chronic suppurative otitis media characterized by ear discharge, membrane perforation and hearing impairment is a major cause of deafness in India. Tympanoplasty with or without mastoidectomy done by postaural, endaural or transcanal approach is the treatment. Each approach has its advantages and limitations. The transcanal approach is becoming more popular today. A detailed study on the merits and demerits of the transcanal approach to tympanoplasty could not be found in the literature. This study compares this with the postaural approach. The study is aimed to evaluate the merits and demerits of transcanal tympanoplasty.

Methods: This study comparing transcanal versus postaural approach in tympanoplasty was carried out between April 2014 and April 2015 for 12 months. A total of 50 patients were divided into two groups (25 each in a group) and compared 11 parameters.

Results: Out of 11 parameters, 5 showed a statistically significant difference between the two, favouring transcanal approach. However, surgical results were similar.

Conclusions: Transcanal approach has more merits and fewer demerits than others for tympanoplasty, with equal hearing results.


Sismanis. Tympanoplasty: Tympanic Membrane Repair. In: Gulya, Minor LB, Poe DS, eds. Glasscock-Shambaugh’s Surgery of the ear. 6th ed. Connecticut: PMPH-USA; 2010: 28: 465.

Farrior JB. Incisions in tympanoplasty: anatomic considerations and indications. The Laryngoscope. 1983;93:75- 86.

1. Sismanis. Tympanoplasty: Tympanic Membrane Repair. In: Gulya, Minor LB, Poe DS, eds. Glasscock-Shambaugh’s Surgery of the ear. 6th ed. Connecticut: PMPH-USA; 2010: 28: 472.

Fadl FA. Outcomes of tympanoplasty-type 1. Saudi Med J. 2003;24(1):58-61.

Shetty S. Pre-operative and post-operative assessment of hearing following tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2012;64(4):377-81.

Gupta S, Kalsotra P. Hearing gain in different types of tympanoplasties. Indian J Otol. 2013;19(4):186-93.

Kumar N, Chilke D, Puttewar MD. Clinical profile of tubotympanic csom and its management with special reference to site and size of tympanic membrane perforation, eustachian tube function and three flap tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2012;64(1):5-12.

Singh MN, Hamam PD, Lyngdoh NC, Priyokumar OS. Evaluation of hearing status in pre and post-operative endoscopic type 1 tympanoplasty and its influencing factors. J Med Societ. 2014;28(3):166-70.

Sharma DK, Singh S, Sohal BS, Singh B. Prospective study of myringoplasty using different approaches. Indian J Otolaryngol Head Neck Surg. 2009;61(4):297-300.

Shaikh AA, Farrukh MS, Mutiullah S, Rafi T, Onali MA. Audiological results of type 1 tympanoplasty by underly technique with temporalis fascia graft. Pak J Otolaryngol. 2009;25:30-1.

Mahadeviah A. Parikh B. Ossiculoplasty. Surgical techniques in Chronic otitis media and Otosclerosis: Text and Atlas. 2nd ed. CBS Publishers; 2008: 93.

Verma R, Gupta R, Bhatia VK, Bogra J, Agarwal SP. Dexmedetomidine and propofol for monitored anesthesia care in the middle ear surgery. Indian J Otol. 2014;20:70-4.

Vyas DA, Hihoriya NH, Gadhavi RA. A comparative study of dexmedetomidine vs. midazolam for sedation and hemodynamic changes during tympanoplasty and modified radical mastoidectomy. Int J Basic Clin Pharmacol. 2013;2(5):562-6.

Gupta K, Bansal M, Gupta PK, Pandey MN, Agarwal. Dexmedetomidine infusion during middle ear surgery under general anaesthesia to provide oligaemic surgical field: A prospective study. Indian J Anaesth. 2015:59(1):26-30.

Moras K, Bhat M, Lasrado S, Jayakumar C, Pinto G. Postaural incision closure in single layer versus multiple layers: a comparison. Indian J Otol. 2014;20:60-2.

Kang HS, Ahn SK, Jeon SY. Sensation recovery of auricle following chronic ear surgery by retroauricular incision. Europ Arch Oto-Rhino-Laryngol. 2012;269(1):101-6.

Frampton SJ, Pringle M. Cutaneous sensory deficit following post-auricular incision. J Laryngol Otol. 2011;125(10):1014-9.

Sismanis. Tympanoplasty: Tympanic Membrane Repair. In: Gulya, Minor LB, Poe DS, editors. Glasscock-Shambaugh’s Surgery of the Ear, 6th Edn Connecticut: PMPH- USA; 2010.28: 469,472.

Tos M. Results of tympanoplasty. Acta Oto-laryngolog. 1973;74:286-7.

Mehta K, Sinha V, Viral A. Chhaya, Barot DA et al. Audiometric and operative results in type 1 tympanoplasty. World Articles Ear Nose Throat. 2009;2(2).

Raj A, Meher R. Endoscopic transcanal myringoplasty-a study. Indian J Otolaryngol Head Neck Surg. 2001; 5:47-9.

Yadav SP, Aggarwal N, Julaha M, Goel A. Endoscope-assisted myringoplasty. Singapore Med J. 2009;50:510-2.

Aich ML, Alam ABMK, Talukder DC, Harun AA, Abdullah M. Outcome of myringoplasty. Bangladesh J Otorhinolaryngol. 2009;15:40-4.

Tawab HM, Gharib FM, Algarf TM and ElSharka LS. Myringoplasty with and without Cortical Mastoidectomy in Treatment of Non-cholesteatomatous Chronic Otitis Media: A Comparative Study. Clin Med Insights: Ear Nose Throat. 2014;7:19-23.

Dornhoffer JL. Hearing results with cartilage tympanoplasty. Laryngoscope. 1997;107:1094-9.

Cueva RA. Areolar temporalis fascia: a reliable graft for tympanoplasty. Am J Otol. 1999;20(6):709-11.

Shelton C. Tympanoplasty results in a residency program. Otolaryngol Head Neck Surg. 1985;93:103-7.

Al-Ghamdi SA. Tympanoplasty: factors influencing surgical outcome. Ann Saudi Med. 1994;14(6):483-5.

Quraishi MS, Jones NS. Day case myringoplasty using tragal perichondrium. Clin Otolaryngol. 1995;20(1):12-4.

Bluestone. Approaches to middle ear and mastoid. In: Bluestone, Rosenfeld, eds. Surg Atlas Paediatr Otolaryngol. 1st ed. London: BC Decker; 2002.

Onal K, Uguz MZ, Kazikdas KC, Gursoy ST, Gokce H. A multivariate analysis of Otological, surgical and patient related factors in determining success in myringoplasty. Clin Otolaryngol. 2005;30(2):115-20.

Halim A, Borgstein J. Paediatric Myringoplasty-postaural versus transmeatal approach. Int J Pediatr Otorhinolaryngol. 2009;73(11):1580-3.






Original Research Articles