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

Laryngoscope. 2015 Oct;125(10):2358-61. doi: 10.1002/lary.25234. Epub 2015 Mar 16.


Objectives/hypothesis: 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.

Study design: Prospective, controlled clinical trial.

Methods: 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.

Results: 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).

Conclusions: 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.

Level of evidence: 4

Keywords: Tensor tympani muscle tendon; conductive; hearing loss; ossiculoplasty; tympanoplasty.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Chronic Disease
  • Ear Ossicles / surgery
  • Female
  • Humans
  • Male
  • Otitis Media / surgery*
  • Prognosis
  • Prospective Studies
  • Tensor Tympani / surgery*
  • Tympanoplasty / methods*