3-flap tympanoplasty — A simple and sure success technique

Objective Three-flap tympanoplasty, a simple method for tympanic membrane repair, is recorded as an alternative method, which probably has advantages over other procedures and its efficacy evaluated Patients Four hundred and fifty patients with subtotal or large central perforations with either an anterior bony overhang or vers small anterior rim of the perforation who underwent 3-flap tympanoplasty were included in this study Follow up period was 24 months Technique After removing the margin of the tympanic membrane remnant, three flaps (Superior, anterior and posterior) were elevated from the external auditory canal wall The temporalis fascia graft was then placed over the handle of malleus and all the three flaps were repositioned over the graft Main outcome measures The graft take over rate and hearing improvement postoperatively were the main outcome measures Results Four hundred and twenty-five patients (94 44%) had successful grafts Both subjective and objective hearing improvement with a compliant tympanic membrane was seen in all of these patients postoperatively Mediatisation or lateralisation of the intact tympanic membrane did not occur Twenty-five patients had graft rejection, which was noted about 4 weeks after surgery and was due to infections Conclusion 3-flap tympanoplasty is a simple technique with a very good success rate It is a useful method for busy practioners and junior otolaryngologists