Latifi Asrar* and Yousef Hassan
Department of ENT, Buraidah Central Hospital, KSAFulltext PDF
Objective: Our message with this paper, mainly to the learners and inexperienced ear surgeons is that: A torn tympanomeatal flap does not need abandoning the procedure; it can be repaired by approximation or with the help of temporalis fascia graft placement over the bare area of the bony canal. Tears in the tympanomeatal flap can occur as linear, buttonhole or separation of flap from the annulus when difficulty is encountered in elevation of the annulus. Most commonly tears occur in the hand of inexperienced otologic surgeons but can also occur in experienced hands. Study Design: Prospective case series. Methods and Results: Seventy (70) cases of Type I tympanoplasty by the underlay technique were studied prospectively during a period of 18 months. (Tympanomeatal flap elevation is essential in placing the graft). Fourteen (14) cases had tear in the tympanomeatal flap. Six (6) of these had small tears like linear or button holes which did not need any repair. Eight (8) cases had large tears, that were repaired by the help of temporalis fascia graft covering the perforation as well as the tear in the tympanomeatal flap. However, while replacing the flap at the conclusion of the procedure, care must be taken to avoid unfolding of the margins of the tear.
Asrar L, Hassan Y. Tear in the Tympanomeatal Flap in Tympanoplasty does it Matter?. Clin Surg. 2022; 7: 3480..