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June 8, 2026
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Abstract

Background: Type I Tympanoplasty is a commonly performed operation in the ENT department that aims to repair a defect in the tympanic membranes, to improve hearing to a serviceable level, and to minimize the occurrence of complications.


Aim of the study: To evaluate the impact of tympanic membrane perforation size on graft take and on hearing improvement in type I tympanoplasty.


Methods: This prospective study was carried out at Al-Shaheed Ghazi Al-Hariri teaching hospital for specialized surgeries in the period between 1st July 2016 to 1st January 2018, in which 50 patients with tympanic membrane perforation underwent type I Tympanoplasty using an underlay temporalis fascia graft. Preoperative and postoperative examination of the patients was carried out by clinical and audiological assessment.


Result: The graft success rate was 84%. Significant predictors of failure included smoking and perforation size >50%. For successful takes, hearing improvement showed a direct correlation with perforation size; the mean air-bone gap (ABG) reduction was 5.25 dB, 14.05 dB, 21.24 dB, and 20.63 dB for small, medium, large, and subtotal perforations, respectively.


Conclusions: The size of tympanic membrane perforation is an important factor affecting graft taking. Hearing loss was associated proportionally with the size of tympanic membrane perforation. Postoperative hearing gain for graft success cases was directly related to the preoperative size of the tympanic membrane perforations.

Keywords

Tympanoplasty type TM perforation Graft success Air-bone gap

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Copyright (c) 2026 Mohammed Aatia Karim

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