Effect of interlay tympanoplasty on anterior tympanomeatal angle and pure tone audiometry at one month, six month and one year follow up
Keywords:Interlay tympanoplasty, Anterior tympanomeatal angle, Anterior perforations, Puretone average
Background: The aim of the study was to determine the effect of interlay tympanoplasty on anterior tympanomeatal angle and on puretone average at 1 month, 6 month and 1 year follow up.
Methods: This study was done at department of Otorhinolaryngology, RMRI, Bareilly, India, a tertiary-care Teaching hospital. A total number of 187 patients (86 females, 101 males) were included in this study from April 2014 to March 2018. Age range of selected patients was 15 years to 62 years, 133 patients were having subtotal perforation and remaining having perforation in the anterior half extending upto the annulus.
Results: The anterior tympanomeatal angle blunting and pure tone audiometry (PTA) at the due follow up time was assessed and results were analyzed in terms of angle of blunting and hearing loss detected by PTA. Anterior tympanomeatal angle (ATA) blunting was categorized in three groups as follows <90o,90-120o and >120o. Only 3 patients were having >120o ATA after one year and mean hearing loss (air bone gap) was significantly less after 1 year follow up. There were only 3 patients with remnant perforation, after 1 year of surgery out of 187 cases, with 98.4% success rate.
Conclusions: Interlay tympanoplasty was significantly effective in repairing anterior and subtotal tympanic membrane perforations with avoidance of blunting at the anterior tympanomeatal angle and achieved good functional results.
Nevoux J, Roger G, Chauvin P, Denoyelle F, Garabedian EN. Cartilage shield tympanoplasty in children, review of 268 consecutive cases. Arch Oto Laryngol Head Neck Surg. 2011;137(1):24-9.
Chen XW, Yang H, Gao RZ, Yu R, Gao ZQ. Perichondrium/cartilage composite graft for repairing large tympanic membrane perforations and hearing improvement. Chinese Med J. 2010;123(3):301-4.
Cavaliere M, Mottola G, Giampiero M, Iemma M. Tragal cartilage in tympanoplasty: Anatomic and functional results in 306 cases. Acta otorhino -laryngologica Italica. 2009;29:27-32.
Adams ME, El-Kashlan HK. Tympanoplasty and ossiculoplasty. Cummins OtorhinoLaryngology and Head and Neck Surgery. 6th edition. Philadelphia: Elsevier Saunders; 2015: 2181-2183.
Mullin DP, Ge X, Jackson RL, Liu J, Pfannenstiel TJ, Balough BJ. Effects of tympanomeatal blunting on sound transfer function. Otolaryngol- Head Neck Surg. 2011;144(6):940-4.
Lin YC, Wang WH, Weng HH, Lin YC. Predictors of surgical and hearing longterm results for inlay cartilage tympanoplasty. Arch Otolaryngol Head Neck Surg. 2011;137:215-9.
Mokhtarinejad F, Okhovat SAR, Barzegar F. Surgical and hearing results of the circumferential subannular grafting technique in tympanoplasty: a randomized clinical study. Am J Otolaryngol Head Neck Med Surg. 2012;33:75-9.
Martin, Michael, Summers, Ian R. Dictionary of Hearing, First Edition. London: Whurr Publishers; 1999: 6.
Salviz M, Bayram O, Bayram AA, Balikci HH, Chatzi T, Paltura C, et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx. 2015;42(1):20-3.
Dispenza F, Battaglia AM, Salvago P, Martines F. Determinants of Failure in the Reconstruction of the Tympanic Membrane: A Case-Control Study. Iran J Otorhinolaryngol. 2018;30:(6):341-6.
Bluher AE, Mannino EA, Strasnick B. Longitudinal analysis of ‘‘window shade’’ tympanoplasty outcomes for anterior marginal tympanic membrane perforations. Otol Neurotol. 2018;40:e173-7.
Castelli ML, Vitiello R, Ponzo S, Evangelista A. Ten years’ experience with Felix tympanoplasty: analysis of anatomical and functional results. J Laryngol Otol. 2015;129:1064-8.
Komune S, Wakizono S, Hisashi K, Uemura T. Interlay method for myringoplasty. Auris Nasus Larynx. 1992;19(1):17-22.
Patil BC, Misale PR, Mane RS, Mohite AA. Outcome of interlay grafting in type 1 tympanoplasty for large central perforation. Indian J Otolaryngol Head Neck Surg. 2014;66(4):418-24.