Is it necessary to retain the tensor tympani tendon in tympanoplasty?

Abstract

To evaluate the acoustic effect after canal wall-down tympanoplasty with sectioning of the tensor tympani muscle (TTM) tendon in patients with chronic otitis media. Prospective, controlled clinical trial. From January 2010 to April 2014, 212 patients underwent canal wall-down tympanoplasty with ossicular chain reconstruction in one-stage surgery. For this study, the patients were assigned to two groups. In group 1 (107 patients), the TTM tensor would be removed during the surgery, whereas it would be retained in group 2 (105 patients). Pre- and postoperative air conduction and bone conduction thresholds at 0.5, 1, 2, and 4 kHz were reported, and the air-bone gaps (ABGs) were measured. Mean postoperative ABG was 16.0 dB in group 1 and 17.0 dB in group 2 and the ABG closure was 11.9 ± 8.5 in group 1 and 11.8 ± 9.7 in group 2. Both were not statistically different (P = .2381 and P = .9625). Overall, 84.1% of patients in group 1 and 75.2% of patients in group 2 attained a postoperative ABG of 20 dB or less. Success rate in group 1 is slightly higher than group 2, but not significant (P = .1255). The section of the tensor tympani muscle tendon in canal wall-down tympanoplasty with ossiculoplasty had no statistically significant influence on sound transmission and can be a safe maneuver in middle ear surgery. 4