Impact of canalplasty on the surgical outcomes of type-1 tympanoplasty: experience in a tertiary care teaching hospital

Context: Canalplasty restores the normal width and shape of the external auditory canal (EAC) for passage of sound. It is required as a co-surgical procedure with tympanoplasty in some cases; where the entire tympanic membrane and anulus cannot be seen during surgery due to the bony overhang or narrowing. Objective: The aim of the study was to determine the surgical outcome of canalplasty in patients with CSOM undergoing type-I tympanoplasty. Widening of the external auditory canal, called canalplasty helps in a better placement of the tympanic membrane graft with a better visualization and with a correct understanding of the effect of canalplasty on the outcome of type I tympanoplasty. Methods: A total of 110 patients diagnosed with chronic otitis media mucosal disease with a central dry perforation involving the tympanic membrane were included. The group A included 55 cases that underwent tympanoplasty with canalplasty; while the group B with 55 cases underwent tympanoplasty without canalplasty. Results: Analysis was done for graft uptake, hearing improvement and time taken for the postoperative recovery. In terms of graft uptake, both groups achieved a success rate of 98.2%. The improvement in postoperative hearing in cases with canalplasty was statistically significant p<0.05. Time taken for complete postoperative recovery in the two groups was statistically insignificant. Conclusion: Anatomical and technical factors diversely affect the functional outcome of tympanoplasties. Canalplasty helped in a better visualization and placement of the graft. Time spent on drilling in canalplasty was compensated by the time gained in grafting of the neo-tympanum. The procedure prevented graft lateralization due to the accurate exposure of the annulus. Postoperative care was easier in cases of tympanoplasty with canalplasty.