Conchal Approach Tympanoplasty

Abstract

Objectives:

(1) Review standard tympanoplasty approaches. (2) Describe a novel approach that minimizes soft tissue dissection and provides good access.

Methods:

The charts of consecutive adult patients who underwent a conchal approach tympanoplasty between January 2010 and December 2012 at an urban teaching hospital under the care of a single surgeon were reviewed. The patient’s age in decades at the time of surgery, sex, and proportion of intact tympanic membranes noted at follow-up were recorded. Postoperative analgesic use and patient recorded satisfaction with the cosmetic appearance of the ear using a Likert type scale from 1 least to 5 most satisfied was collected for consecutive patients undergoing the procedure in 2013. The mean patient satisfaction score was calculated.

Results:

In the 3-year period from 2010-2012, the charts of 75 adults were reviewed. There were 45 females and 30 males with ages ranging from third to eighth decades. Complete tympanic membrane closure was achieved in 74 (98.7%). Twenty-one adults treated in 2013 recorded a mean satisfaction score with the appearance of the postoperative ear scar of 4.8 out of 5. Postoperative analgesic consumption consisted of acetaminophen or diclofenac sodium on the day of surgery. No patients used analgesics beyond postoperative day 2.

Conclusions:

The conchal approach tympanoplasty is associated with a high graft take rate, low morbidity and high patient satisfaction with scar cosmesis.