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Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane perforations

Published online by Cambridge University Press:  18 June 2018

D E M El-Hennawi ,
M R Ahmed ,
A S Abou-Halawa  and
M A Al-Hamtary
D E M El-Hennawi
Affiliation:
Otolaryngology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
M R Ahmed*
Affiliation:
Otolaryngology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
A S Abou-Halawa
Affiliation:
Otolaryngology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
M A Al-Hamtary
Affiliation:
Otolaryngology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
*
Author for correspondence: Dr Mohammed Rifaat Ahmed, Otolaryngology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt E-mail: [email protected] Fax: +20 663 415 603
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Abstract

Background

Microscopic myringoplasty is the most frequently performed procedure for repairing tympanic membrane perforations. The endoscopic transcanal approach bypasses the narrow ear canal segment and provides a wider view.

Methods

An open-label randomised clinical trial was conducted on 56 patients with small anterior tympanic membrane perforations. Perforations were repaired with an endoscopic push-through technique (n = 28) or a microscopic underlay technique (n = 28). Follow up was conducted using endoscopic examination and pure tone audiometry three months’ post-operatively.

Results

Graft success rate was 92.9 per cent in the endoscopic group versus 85.7 per cent in the microscopic group. The corresponding pre-operative mean air–bone gaps were 17.4 dB and 18.5 dB, improving to 6.1 dB and 9.3 dB post-operatively (p > 0.05). Mean air–bone gap closure was 11.4 dB in the endoscopic group and 9.2 dB in the microscopic group (p > 0.05). Mean operative time and estimated blood loss were 37.0 minutes and 29 ml in the endoscopic group, versus 107 minutes and 153 ml in the microscopic group (both p < 0.05).

Conclusion

The endoscopic push-through technique for anterior tympanic membrane perforations is as effective as microscopic underlay myringoplasty; furthermore, it is less invasive and takes less operative time.

Keywords

Middle EarGraftsTympanoplastyOtologic Surgical ProceduresOtitis Media
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 6 , June 2018 , pp. 509 - 513
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr M R Ahmed takes responsibility for the integrity of the content of the paper

References

1Tarabichi, M. Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg 2010;62:6–24Google Scholar
2Celik, H, Samim, E, Oztuna, D. Endoscopic “push-through” technique cartilage myringoplasty in anterior tympanic membrane perforations. Clin Exp Otorhinolaryngol 2015;8:224–9Google Scholar
3Peng, R, Lalwani, A. Efficacy of “hammock” tympanoplasty in the treatment of anterior perforations. Laryngoscope 2013;123:1236–40Google Scholar
4Gavriel, H, Eviatar, E. Inferior flap tympanoplasty: a novel technique for anterior perforation closure. Biomed Res Int 2013;2013:758598Google Scholar
5Ayache, S. Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol 2013;270:853–60Google Scholar
6Tarabichi, M, Nogueira, JF, Marchioni, D, Presutti, L, Pothier, DD, Ayache, S. Transcanal endoscopic management of cholesteatoma. Otolaryngol Clin North Am 2013;46:107–30Google Scholar
7Badr-El-Dine, M, James, AL, Panetti, G, Marchioni, D, Presutti, L, Nogueira, JF. Instrumentation and technologies in endoscopic ear surgery. Otolaryngol Clin North Am 2013;46:211–25Google Scholar
8Glasscock, ME 3rd, Gulya, AJ, eds. Glasscock-Shambaugh's Surgery of the Ear, 5th edn. Hamilton, Ontario: BC Decker, 2003Google Scholar
9Yung, M. Cartilage tympanoplasty: literature review. J Laryngol Otol 2008;122:663–72Google Scholar
10Pothier, DD. Introducing endoscopic ear surgery into practice. Otolaryngol Clin North Am 2013;46:245–55Google Scholar
11Presutti, L, Marchioni, D, Mattioli, F, Villari, D. Endoscopic management of acquired cholesteatoma: our experience. J Otolaryngol Head Neck Surg 2008;37:481–7Google Scholar
12Dündar, R, Kulduk, E, Soy, FK, Aslan, M, Hanci, D, Muluk, NB et al. Endoscopic versus microscopic approach to type 1 tympanoplasty in children. Int J Pediatr Otorhinolaryngol 2014;78:1084–9Google Scholar
13Choi, N, Noh, Y, Park, W, Lee, JJ, Yook, S, Choi, JE et al. Comparison of endoscopic tympanoplasty to microscopic tympanoplasty. Clin Exp Otorhinolaryngol 2017;10:44–9Google Scholar
14Nassif, N, Berlucchi, M, Radaelli de Zinis, LO. Tympanic membrane perforation in children: endoscopic type I tympanoplasty, a newly technique, is it worthwhile? Int J Pediatr Otorhinolaryngol 2015;79:1860–4Google Scholar
15Lade, H, Choudhary, SR, Vashishth, A. Endoscopic vs microscopic myringoplasty: a different perspective. Eur Arch Otorhinolaryngol 2014;271:1897–902Google Scholar
16Dornhoffer, JL. Cartilage tympanoplasty: indications, techniques, and outcomes in a 1,000 patient series. Laryngoscope 2003;113:1844–56CrossRefGoogle Scholar