Comparative study between anterior tucking and tunneling of graft in Type-1 tympanoplasty

Background: Tympanoplasty is the surgical procedure performed to repair a perforated tympanic membrane, with or without reconstruction of the ossicles, with the aim of preventing reinfection and restoring hearing ability. There are various techniques to perform Type 1 tympanoplasty. Aims and Objectives: • To compare anterior tucking and tunneling of temporalis fascia graft in Type 1 tympanoplasty based on the clinical and audiological outcome. • To study the hearing outcome and graft uptake in anterior tucking technique and anterior tunneling technique in Type 1 tympanoplasty. • To compare the hearing outcome and graft uptake in anterior tucking versus anterior tunneling technique in Type 1 tympanoplasty. Materials and Methods: The study was carried out in the Department of Otorhinolaryngology (ENT), Maharishi Markandeshwar Institute of Medical Sciences and Research Hospital, Mullana over 2 years from September 2020 to September 2022. One hundred cases of inactive, chronic otitis media (COM) were included in this study and subjected to Type 1 tympanoplasty with 50 belonging to the anterior tucking technique (Group A) and 50 to the anterior tunneling technique (Group B). Results: The graft uptake rate was 96% in Group A (anterior tucking technique) and 98% in Group B (anterior tunneling technique). The average hearing gain in Group A was 9.94 dB and in Group B was 9.36. Chances of complications like residual perforation were found to be low (4% in Group A and 2% in Group B) in both techniques. Conclusion: In our study, we concluded that both the techniques of anterior tucking and anterior tunneling of temporalis fascia graft in Type 1 tympanoplasty surgery are equally effective to achieve intactness of graft and hearing improvement in patients of inactive, mucosal COM.