Outcome of the Kerr Anterior Tab Flap in a tertiary care center in western Nepal

Abstract

Objective: This study aimed to evaluate the outcome of myringoplasty using the Kerr flap technique in all cases of tympanic membrane (TM) perforations involving the anterior region as well as noting the concern of hearing gain, Air-Bone gap (AB gap) closure and incidence of complications. Methods: This prospective study recruited 118 patients who underwent myringoplasty using the Kerr flap technique between 2021 and 2024. The effects of the surgical treatment were assessed by changes in pre- and postoperative Pure tone Audiogram (PTA) and AB gap data as well as complication rates. Results: The patients included in the study had chronic TM perforations, and significant surgical improvements in PTA and AB gap outcomes were observed. The technique of the Kerr flap was effective in achieving success for graft fixation as well as maintaining tension in the anterior segment to effectively close the AB gap with a median of 9.7 decibels (dB). This study showed a high success rate using the method showing only one patient with complication (ear discharge) that was managed conservatively. Conclusion: The Kerr flap technique in myringoplasty is efficient in terms of hearing gains and a relatively low complication rate mainly in anterior region TM perforations. Based on the capacity to offer sufficient fixation and tension toward the anterior segment of the graft, it is considered as beneficial and adjustable in otologic surgery for addressing different TM repair concerns.

Keywords: Kerr Anterior, myringoplasty, tympanic membrane