Retrospective study on post-operative outcomes of incisura terminalis incision in tympanoplasty with post canaloplasty ear surgeries

Background: The incisura terminalis (IT), a natural bony notch at the junction of the cartilaginous and osseous external auditory canal (EAC), provides a surgically favourable site for canaloplasty incisions. Conventional approaches such as postauricular or endaural incisions may risk vascular disruption, fibrosis, or restenosis. This study evaluates the postoperative outcomes, safety, and efficacy of IT-based incisions in canaloplasty procedures.Materials and Methods: A retrospective analysis was conducted on 100 patients who underwent canaloplasty with an IT-based incision at the Department of ENT, Basaveshwara Medical College and Hospital, Chitradurga, between March to December 2024. Parameters assessed included wound healing, infection rates, postoperative stenosis, and hearing outcomes using pure-tone audiometry. Statistical analysis was performed using SPSS v28, with a p-value < 0.05 considered significant.Results: Primary intention healing occurred in 88% of patients, while 12% showed minor granulation requiring topical therapy. Postoperative infection rate was 6%, and no neurovascular complications were observed. Mild canal restenosis developed in 10%, with no moderate or severe cases. Audiometric evaluation demonstrated a mean air–bone gap improvement of 16.3 dB (p < 0.001) and a pure-tone average gain of 14.7 dB at 3 months postoperatively. Smoking was identified as a significant predictor of minor restenosis (p = 0.03).Conclusion: The IT-based incision provides an anatomically safe and functionally superior approach for canaloplasty. It offers enhanced exposure, minimal tissue trauma, faster epithelialization, and a low incidence of postoperative stenosis and infection. Given its safety and efficacy, the IT incision represents a valuable modification in EAC and middle ear reconstructive surgery. Further prospective, long-term studies are recommended to validate these results.