{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T14:04:39Z","timestamp":1784988279053,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Leadership Project of Chunshen Pyramid Talents Program"},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82271167"],"award-info":[{"award-number":["82271167"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Medical Innovation Research Project of Shanghai 2022 \u201cScience and Technology Innovation Action Plan\u201d","award":["22Y11901900"],"award-info":[{"award-number":["22Y11901900"]}]},{"name":"the Top-notch Project of Shanghai Oriental Talents Program"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare audiological and anatomical outcomes between preservation and resection of the anterior malleolar handle during endoscopic tympanoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective comparative study was performed in 45 patients with chronic suppurative otitis media who underwent endoscopic tympanic membrane repair between January 2022 and April 2025. Patients were divided according to intraoperative management of the anterior malleolar handle into a preservation group (Group A, n = 23) and a resection group (Group B, n = 22). The decision to preserve or resect the anterior malleolar handle was made intraoperatively based on surgical exposure, epithelial adhesion at the malleolar tip, and graft stability. Audiological outcomes, tympanic membrane healing, and postoperative complications were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant postoperative improvement in air\u2013bone gap (ABG) was observed in both groups. Mean ABG improved from 18.87 \u00b1 7.95 dB HL to 13.70 \u00b1 4.69 dB HL in Group A (P = .002) and from 20.10 \u00b1 6.59 dB HL to 15.75 \u00b1 5.67 dB HL in Group B (P = .009). No significant differences were found between groups in preoperative ABG, postoperative ABG, or ABG closure. Functional hearing success (postoperative ABG \u226420 dB HL) was achieved in 91.3% of patients in Group A and 77.3% in Group B (P = .243). Tympanic membrane closure was achieved in 91% of patients in both groups. No postoperative facial paralysis or vertigo occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both preservation and resection of the anterior malleolar handle were associated with significant hearing improvement and high graft healing rates following endoscopic tympanoplasty. Within the limitations of this retrospective study, limited resection of the anterior malleolar handle may be a useful option when additional surgical exposure or graft stability is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01455613261467084","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:23:43Z","timestamp":1784723023000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preservation Versus Resection of the Anterior Malleolar Handle During Endoscopic Tympanoplasty: A Retrospective Comparative Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0394-7331","authenticated-orcid":false,"given":"Yang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, ENT institute, Eye & ENT Hospital of Fudan University"},{"name":"Fudan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, ENT institute, Eye & ENT Hospital of Fudan University"},{"name":"Fudan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Qingdao Central Hospital of University of Health and Rehabilitation Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingfang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, ENT institute, Eye & ENT Hospital of Fudan University"},{"name":"Fudan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-1562","authenticated-orcid":false,"given":"Yunfeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, ENT institute, Eye & ENT Hospital of Fudan University"},{"name":"Fudan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00259-9"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2020.09.016"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-021-01051-y"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.03.012"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.5152\/iao.2015.1011"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2016.05.016"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25904"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/ONO.0000000000000005"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2022.01599"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2056-x"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-022-00597-3"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-022-07451-2"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2020.09.023"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-017-4570-3"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-05992-y"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2020.1834616"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2024.101509"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.0601"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otoeng.2019.02.003"}],"container-title":["Ear, Nose &amp; 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