Efficacy of Anterior Tucking vs Conventional Method of Type 1 Tympanoplasty: A Comparative Study

Abstract

Introduction: Type I tympanoplasty is performed to reconstruct the tympanic membrane and restore middle ear function. Several surgical modifications have been proposed to enhance graft uptake and hearing outcomes, particularly in anterior quadrant and subtotal perforations. This study evaluates the effectiveness of the anterior tucking technique compared with the conventional method.

Aim & Objective: To compare graft uptake rates and postoperative hearing outcomes between anterior tucking and conventional Type I tympanoplasty in patients with chronic suppurative otitis media (CSOM).

Materials & Methods: This prospective observational study included 78 patients with CSOM, randomly allocated into two equal groups: Group I (anterior tucking technique, n = 39) and Group II (conventional technique, n = 39). Preoperative and postoperative audiological assessments including air conduction, bone conduction, and air–bone gap (ABG) were performed. Graft status was evaluated using otoendoscopy at 0, 6, and 12 weeks postoperatively. Statistical analysis was conducted using SPSS version 20.

Results: Both groups were comparable in baseline demographic characteristics. Graft uptake was observed in 100% of patients in the anterior tucking group and 92.3% in the conventional group; however, the difference was not statistically significant (p = 0.241). Postoperative hearing improvement, assessed by ABG closure at 6 and 12 weeks, showed no statistically significant difference between the two groups (p > 0.05). Overall, 74.36% of patients demonstrated satisfactory hearing improvement, with no significant correlation between graft uptake and degree of hearing gain (p = 0.156).

Conclusion: Anterior tucking and conventional Type I tympanoplasty techniques demonstrate comparable efficacy in terms of graft uptake and hearing outcomes. Surgical technique selection may therefore be guided by surgeon preference and intraoperative anatomical considerations without adversely affecting clinical results.