The importance of tympanic cavity revision during tympanoplasty

The frequency of repeat surgical interventions in patients with chronic suppurative otitis media is associated with many factors, including neglect of careful revision of all parts of the middle ear. This paper assesses the results of revising the inner surface of the tympanic membrane and the tympanic cavity during primary tympanoplasties. Subjects and methods. A total of 123 patients diagnosed with chronic tubotympanic suppurative otitis media were operated on in January 2017 to December 2019. Intraoperative findings were analyzed during revision surgery. Results. Classical refreshing of the edges of the defect was insufficient to completely remove the epidermis from the inner surface of the tympanic membrane remnants in 12 (9.8%) cases. The epidermis extended along the posterior surface of the handle of the malleus, the long process of the incus, and the posterior crus of the stapes, reaching the pyramidal process in 3 (2.4%) cases. Hypotympanic and protympanic epidermal growth was observed in 2 (1.6%). Conclusion. Thorough revision of all parts of the tympanic cavity, including the inner surface of the tympanic membrane, is an important condition for a good result of surgery and prevention of disease recurrence.

otorhinolaryngology, surgery, chronic suppurative otitis media, revision, tympanoplasty, tympanic membrane