Management of conductive hearing loss in tympanic perforation: Novel techniques and materials

Tympanic membrane (TM) perforation is a common medical condition often resulting from trauma or infection. TM perforation can lead to significant morbidity including pain, recurrent infections and conductive hearing loss. There are many methods of TM repair that have evolved to incorporate advancements in technology and reduce procedural burden. Three methods of repair that will be discussed include: transcanal endoscopic tympanoplasty, total drum replacement tympanoplasty, and in office TM repair. The size and location of the perforation, in addition to patient factors and physician preference influence the type of repair indicated. Closure rate of TM perforations and conductive hearing loss improvement have been shown to be similar across techniques. Steps to successfully master each technique including preoperative indications, specific surgical steps, and expected postoperative outcomes are discussed herein.