Outcomes of Inverted Tympanomeatal Flap Elevation for Large Anterior Tympanic Membrane Perforations in Narrow External Auditory Canals

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dc.contributor.authorBelada, Abdullah
dc.date.accessioned2026-07-01T11:40:15Z
dc.date.available2026-07-01T11:40:15Z
dc.date.issued2026
dc.departmentDüzce Üniversitesi
dc.description.abstractBackground and Objective Anterior tympanic membrane perforations-particularly in patients with a narrow external auditory canal-remain technically challenging due to limited visualization and inadequate anterior support. The inverted tympanomeatal flap technique has been proposed to address these issues, but evidence is limited. This study aimed to evaluate its anatomical and functional outcomes in large anterior perforations treated with endoscopic transcanal tympanoplasty. Methods This retrospective single-surgeon study included 70 patients with large anterior perforations and >= 20% anterior quadrant non-visualization. All underwent standardized audiometry and at least 6 months of follow-up. Outcomes were graft success, complications, and hearing improvement. Analyses included audiometric comparisons, logistic regression, and ROC curves to identify predictors of graft failure. Results The graft success rate was 95.7% (67/70). Mean ABG improved from 23.44 +/- 10.95 dB preoperatively to 13.52 +/- 8.86 dB postoperatively (p < 0.001), with a mean hearing gain of 9.91 +/- 8.61 dB (Cohen's d = 1.00). Larger perforation size (p = 0.046) and severe external auditory canal narrowing (p = 0.041) independently predicted graft failure. ROC analysis identified > 72% perforation size (AUC = 0.78) and > 40% canal narrowing (AUC = 0.71) as risk thresholds. No cases of chorda tympani injury, canal trauma, or iatrogenic cholesteatoma occurred. Conclusion In conclusion, inverted tympanomeatal flap elevation showed favorable graft success and hearing improvement in challenging anterior perforations with narrow canals. However, due to the retrospective single-surgeon design and absence of a control group, these results should be interpreted cautiously. Larger prospective studies are needed to validate its effectiveness.
dc.identifier.doi10.1002/lio2.70375
dc.identifier.issn2378-8038
dc.identifier.issue2
dc.identifier.pmid42057911
dc.identifier.scopus2-s2.0-105032665602
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://doi.org/10.1002/lio2.70375
dc.identifier.urihttps://hdl.handle.net/20.500.12684/23725
dc.identifier.volume11
dc.identifier.wosWOS:001714549100001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorBelada, Abdullah
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofLaryngoscope Investigative Otolaryngology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260623
dc.subject[Keyword Not Available]
dc.titleOutcomes of Inverted Tympanomeatal Flap Elevation for Large Anterior Tympanic Membrane Perforations in Narrow External Auditory Canals
dc.typeArticle

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