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BioMed Research International
Volume 2013, Article ID 758598, 4 pages
Research Article

Inferior Flap Tympanoplasty: A Novel Technique for Anterior Perforation Closure

1Department of Otolaryngology Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin 70300, Israel
2Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel

Received 14 May 2013; Revised 14 July 2013; Accepted 15 July 2013

Academic Editor: Peter S. Roland

Copyright © 2013 Haim Gavriel and Ephraim Eviatar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To report a novel tympanoplasty modification for anterior tympanic membrane perforation closure. Materials and Methods. A prospective study on 13 patients who underwent inferior tympanoplasty between December 2008 and May 2011 was carried out. In our technique, an inferior rather than a posterior flap is raised and the graft is laid from the inferior direction to obtain better access to the anterior part of the tympanic membrane perforation and provide better support. Results. A total of 13 patients underwent the novel inferior tympanoplasty technique with a mean age of 33 years. Six patients had undergone tympanoplasties and/or mastoidectomies in the past, 3 in the contralateral ear. A marginal perforation was observed in 3 cases, total perforation in 2 and subtotal in 1 case. The mean preoperative pure-tone average was 40.4 dB (10 to 90 dB), compared to 26.5 dB (10 to 55 dB) postoperatively. All perforations were found to be closed but one (92.3% success rate). Conclusions. The inferior tympanoplasty technique provides a favorable outcome in terms of tympanic membrane closure and hearing improvement for anterior perforations, even in difficult and complex cases. It is based on a well-known technique and is easy to implement.