A study on tympanoplasty with or without canaloplasty

Abstract
Background
Chronic otitis media is a highly prevalent disease in developing as well as developed countries, causing hearing disabilities to the patients and causing huge problems to the patients in their daily routine lives. The patients are routinely advised for tympanoplasties in the specialized centers. Canaloplasties are routinely performed in such patients to get wide exposure while doing tympanoplasties. The present study seeks to determine the impact of canaloplasty on the outcome of the tympanoplasty.

Material and methods
The study was conducted in Department of Otorhinolaryngology at the Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, between 2018 and 2020, in which 70 patients were included. These patients were randomly divided into two groups. Group A patients underwent type I tympanoplasty with canaloplasty while group B patients underwent type I tympanoplasty alone. Patients in both the groups were followed up with pure tone audiometry and otoscopy at 6 weeks and 12 weeks postoperatively. Hearing was compared in both the groups in terms of air bone gap closure. Air bone gap closure at 12 weeks was considered final. Final analysis was done using SPSS version 21.0.

Results
The patients were randomly divided into two groups. Group A patients underwent type 1 tympanoplasty with canaloplasty, and group B comprises of case l graft tympanoplasty alone. Graft uptake was better in group A with a success rate of 94.3% as compared to group B which had a success rate of 88.57%. Air bone gap closure was better in group A as compared to group B (15.76 dB ± 6.75 v/s 14.87 dB ± 5.99) at 12 weeks postoperatively.

Conclusion
Tympanoplasty with canaloplasty showed advantageous outcome over tympanoplasty alone and thus should be considered with limited exposures. However, the final decision resides with the operating surgeon.