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Longitudinal Analysis of “Window ShadeTympanoplasty Outcomes for Anterior Marginal Tympanic Membrane Perforations

Bluher, Andrew E.; Mannino, Elizabeth A.; Strasnick, Barry

doi: 10.1097/MAO.0000000000002147

Objectives: Although many techniques have been proposed for the repair of tympanic membrane perforations, few address the unique challenges presented by anterior marginal perforations. In these circumstances, traditional underlay and overlay techniques are often complicated by issues including blunting of the anterior tympanomeatal angle, graft lateralization, delayed healing, and reduced graft take rates. The “window shadetympanoplasty technique described in this paper incorporates several aspects of the underlay and overlay techniques to address these issues.

Study Design and Setting: A retrospective chart review was conducted at an academic medical center, of all patients who underwent window shade tympanoplasty from 1994 to 2016 by a single surgeon.

Patients: A total of 412 patients aged 6 to 76 years old were included in the study. Patients who had undergone concomitant ossicular chain reconstruction were excluded from the hearing outcome portion of the analysis.

Main Outcome Measures: Any patients observed to have residual postoperative perforations within the first 6 months after surgery were considered to have graft failure. Complications such as otorrhea, serous otitis media, epithelial pearls, and post-auricular infection were tabulated. Air-bone gap closure was also assessed.

Results: Postoperative outcomes of 412 patients were assessed including graft take rate, complication rates, and air-bone gap closure. The graft take success rate was 94.2%. Overall complication rate was 4.6%. 82.6% of patients achieved air-bone gap closure within 10 dB.

Conclusions: The results of this study further reinforce the success of the window shade technique in repairing anterior marginal tympanic membrane perforations.

Department of Otolaryngology–Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia

Address correspondence and reprint requests to Barry Strasnick, M.D., F.A.C.S., Department of Otolaryngology–Head and Neck Surgery, 600 Gresham Drive, Suite 1100, Norfolk, VA 23507; E-mail:

Level of Evidence: Level IV, Case Series.

Funding: No funding was obtained for this study, nor are any commercial products mentioned.

Meeting Information: American Otological Society; National Harbor, Maryland: April 2018.

There are no relevant conflicts of interest to disclose.

Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company