title: A novel myringoplasty technique: the placement of a complementary graft descending from the scutum to support an anterosuperior perforation.
abstract: We describe a novel myringoplasty procedure. We placed a separated fascia graft descending from the scutum, combined with underlay myringoplasty, to support an anterosuperior perforation. We reviewed data from patients who underwent myringoplasty procedures to treat perforations extending into the anterosuperior quadrant of the pars tensa from October 2012 to June 2014. A total of 42 patients who were followed for a minimum of 1 year were enrolled. The same technique was used in all operations. The tympanomeatal flap was elevated from the neck of malleus up to the tip of the lateral process of malleus. The anterior mallear fold was incised to create an opening running from the neck of the malleus to the anterior tympanic spine. A separate temporal fascia graft (complementary graft) was next inserted through the opening and pushed down into the protympanum. The upper part of the fascia graft was placed over the superior bony wall of the canal. Underlay myringoplasty was then performed. The inferior part of the fascia graft was next spread out to cover the lateral surface of the underlying graft. We measured graft take rate and preoperative and postoperative hearing parameters. The graft success rate was 97.7 % (41/42 patients). The preoperative air-bone gap was 22.56 ± 18.12 dB, and the postoperative air-bone gap was 8.4 ± 10.05 dB. This difference was statistically significant (P < 0.001). We believe that this myringoplasty technique is a safe, suitable, and effective for cases with tympanic membrane perforations extending into the anterosuperior quadrant of the pars tensa.
authors: Department of Audilogy, School of Health Sciences, Gelisim University, Istanbul, Turkey. erdalkbb1979@hotmail.com.|Fevzi cakmak mah. Sisecam bloklari, Emek apt. D:8, Bagcilar, Istanbul, Turkey. erdalkbb1979@hotmail.com.
authors: Erdal
authors: E
authors: Sakalli
authors: Department of Otorhinolaryngology, Safa Private Hospital, Istanbul, Turkey.
authors: Cengiz
authors: C
authors: Celikyurt
authors: Department of Otorhinolaryngology, Bulent Ecevit University Medical Faculty, Zonguldak, Turkey.
authors: Sultan
authors: S
authors: Biskin
authors: Department of Audilogy, School of Health Sciences, Aydin University, Istanbul, Turkey.
authors: Selcuk Cem
authors: SC
authors: Erdurak
mesh_terms: D000293:Adolescent; D000328:Adult; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D012189:Retrospective Studies; D014432:Tympanic Membrane / Q000601:surgery; D018058:Tympanic Membrane Perforation / Q000601:surgery*; D055815:Young Adult
keywords: Anterior perforation; Myringoplasty; Tympanic membrane; Underlay