Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation

Abstract

Objective The purpose of the study is to compare the clinical outcome of the two techniques of Bucket Handle Tympanoplasty and Cartilage Tympanoplasty in achieving success in graft survival as well as acceptable auditory results. 60 patients who suffered chronic otitis media with anterior perforation of the tympanic membrane were chosen. The patients were randomly assigned using Block Randomization Method of two groups including patients who underwent Bucket Handle Tympanoplasty (n = 30) or those that underwent Cartilage Tympanoplasty (n = 30). The patients were followed up for 1, 3, 6, and 12 months postoperatively. Results The mean PTA was lower in Bucket Handle Tympanoplasty group as case group compared to Cartilage Tympanoplasty group as the control (P = 0.023). No significant statistical differences had identified passing through the time, in terms of PTA outcome (P Value = 0.547) and SRT outcome (P Value = 0.352), between Bucket Handle Tympanoplasty group and the Cartilage Tympanoplasty group. In total, postoperative tympanic membrane perforation was found in 10.0% of patients in Cartilage Tympanoplasty group and 13.3% in Bucket Handle Tympanoplasty group with no difference (P = 0.500). Conclusions Hearing improvements in both methods were similar. Registration Number The trial is registered with IRCT2016022626773N1.

Success rates in restoring hearing loss in patients with chronic otitis media: A systematic review

“…On examining the full texts, 92 articles were assessed as unsuitable where COM was not the primary disease (7), tympanoplasty subtypes were not the primary intervention (11), the article was not published in English (5), the article did not contain long‐term hearing outcomes (68) or the presented data were too limited (1). Thirty‐nine studies 14‐52 reporting long‐term hearing outcomes and/or complications following middle ear interventions were included for synthesis.…”

“…Mean preoperative and postoperative pure tone audiometry was reported in accordance with the inclusion criteria, and was therefore suitable for quantitative synthesis, in 21 studies 14,17,18,20,21,24,25,31,32,36‐39,42,45‐47,49‐52 . 10 of these studies 20,21,24,25,32,38,39,42,45,52 reported air‐bone gap (ABG) data in sufficient detail so that it could be categorized in to bins of ≤20 dB HL or ˃20 dB HL.…”

“…Regarding complications, 31 14,15,17,19‐27,29‐32,34‐39,41‐44,46,47,49‐51 studies presented complications data, however, three of these studies 30,41,54 presented complications data in terms of ears and could not be included in the data synthesis calculation, which is based on complication per patient. The mean complication rate, calculated for a total of 3162 patients from the remaining studies, was 14.0% (Figure 4).…”

Impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes: a retrospective analysis in patients with tympanic membrane perforation due to chronic otitis media

“…Tympanoplasty using a temporalis fascia graft is a mainstay surgical approach for the management of tympanic membrane perforation due to chronic otitis media, where the aim is to create a dry and non-infected environment in the ear, repair the perforated membrane, eradicate infection, and restore hearing loss. 1–4 Although use of temporalis fascia in initial tympanoplasties has been associated with high surgical success rates (93–97 per cent), 5 post-operative outcomes are largely unpredictable given the structural composition of fascia temporalis, which exhibits irregular elastic fibres and fibrous connective tissue. 6 Thus, various types of graft materials (e.g.…”