Tympanoplasty type-1. Endaural or postaural approach. Should the patient decide?

OBJECTIVE: To examine the preferred patient approach to chronic suppurative otitis media (CSOM) of the safe type.

METHODS: We designed a prospective study to note the variables in the patient's initial choice for approach to CSOM of the safe type at Buraidah Central Hospital, Al-Qassim, Saudi Arabia from January 2003 to December 2004.

RESULTS: During the 24-month study period, we included 63 consecutive patients diagnosed with CSOM of the safe type. We excluded patients with perforations associated with cholesteatomata, polyps, and acute infections. We administered a questionnaire discussing the options for the operation, and found most males preferred the endaural approach, and most females preferred the postaural approach.

CONCLUSION: There was a significant preference by younger age groups for the postaural approach, especially younger females. They were more concerned about the site, visibility, and cosmetic result from the scar, and could camouflage the scar behind the pinna by hair or a traditional headscarf.