Comparative study of tympanoplasty in wet perforation v/s totally dry perforation in tubotympanic disease.

In our initial experience the failure rate in totally dry ear Tympanoplasty were more as compared to wet Tympanoplasty. Hence we suspected the avascularity of totally dry tympanic membrane is the cause for such failures. So we did histopathological study of both types of remnant tympanic membrane & compared the finding. According to the results we infer that graft take up rate is better in wet central perforation than totally dry perforation following tympanoplasty, so is the success rate. This also correlates with our clinical experience. We have further seen that such types of failures can he prevented, if(i) the central perforation is converted to subtotal perforation by removing the necrotic portion of the TM, (ii) stabilization of the underlay graft by antero-superior anchoring myringoplasty in which a window in the anterior canal skin is made at about 3 O'clock position in right ear & 9 O'clock position in left ear and the graft is tucked under it.