title: Comparison between transtympanic and elevation of tympanomeatal flap approaches in tympanoplasty.
abstract: OBJECTIVE
  Transtympanic tympanoplasty is an easy way of introducing a graft through the tympanic membrane to repair a perforation. The aim of our study is to compare the transtympanic technique with the usual method of elevating a tympanomeatal flap.
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  Tertiary referral teaching hospital.
  
  
  METHODS
  Patients undergoing surgery for tympanic membrane perforations by the ENT team of King Abdullah University hospital between April 2004 and June 2009.
  
  
  METHODS
  Surgery.
  
  
  METHODS
  Perforations were stratified according to their sizes. Hearing was assessed preoperatively and postoperatively. The success rates defined as perforation closure and hearing improvement were compared between the 2 groups.
  
  
  RESULTS
  A total number of 61 patients were enrolled in this study; 29 patients underwent the transtympanic approach, and 32 patients had a tympanomeatal flap elevated under general anesthesia. There was no statistical difference in the success rate between the 2 groups for all perforation sizes, although the tympanomeatal flap elevation technique was more effective in large perforations. There was a statistically significant average of 9 minutes saved in the transtympanic approach. There was a significant advantage in hearing improvement at 1 kHz favoring the transtympanic method.
  
  
  CONCLUSIONS
  Transtympanic tympanoplasty is a simple technique with comparable success rate to the tympanomeatal flap technique in tympanic membrane closure and hearing results. We recommend it for small- and medium-sized perforations.
authors.affiliation: Division of Otorhinolaryngology, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. firasz@just.edu.jo
authors.forename: Firas Q
authors.initials: FQ
authors.lastname: Alzoubi
authors.forename: Amjed A
authors.initials: AA
authors.lastname: Tarifi
authors.forename: Yousef
authors.initials: Y
authors.lastname: Khader
authors.forename: John
authors.initials: J
authors.lastname: de Carpentier
mesh_terms: D000328:Adult; D001298:Audiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology* / Q000601:surgery*; D018058:Tympanic Membrane Perforation / Q000473:pathology* / Q000601:surgery*; D014433:Tympanoplasty / Q000379:methods*