3b.

Background To compare the results between type I tympanoplasty performed with transcanal endoscopic ear surgery (TEES) and microscopic ear surgery (MES) for treatment of chronic otitis media in a homogenous group of patients. Methods A retrospective study was performed in our department between January 2011 and January 2016 to review primary type I tympanoplasty cases with a subtotal perforation, an intact ossicular chain, a dry ear for at least 1 month, normal middle ear mucosa, and a follow-up period of at least 6 months post surgery. The adoption of TEES or MES was divided temporally (before and since 2013). TEES was undertaken in 224 patients (224 ears) and MES in 121 patients (121 ears). Results The successful graft take rate was 94.64% (212/224) in the TEES group and 90.91% (110/121) in the MES group (P = 0.239). The improvements in the air conduction levels between the 2 groups were not statistically different at 1, 3, or 6 (> 6) months (P > 0.05) after surgery. The improvements in the air–bone gaps were not significantly different between the 2 groups (P > 0.05). The average hearing gains in the TEES group 6 (and > 6) months post surgery were 11.85 ± 5.47 dB, which was better than 10.48 ± 5.18 dB in the MES group (P = 0.031). The use of medical resources was lower in the TEES group than in the MES group regarding the average operating time (49.22 ± 8.24 min vs 81.22 ± 14.73 min, respectively; P < 0.0001). Patients receiving MES had a significant higher incidence of the wound problems (ear pain, numbness around the ears, and wet ear; P < 0.05). Conclusion TEES for type I tympanoplasty seems to achieve a shorter operative time and ideal tympanic membrane healing rate and hearing results in patients with chronic otitis media.

Objectives The aim of this study was to evaluate whether adding an extra perichondrium patch to enhance the cartilage graft during endoscopic myringoplasty can improve the healing rate and post-operative hearing of patients with poor prognostic factors (eustachian tube dysfunction, large perforations, subtotal perforations and marginal perforations). Methods This retrospective study analyzed a total of 80 patients (40 females and 40 males, median age of 40.55 years) who had received an extra patch during endoscopic cartilage myringoplasty. Patients were followed up for six months. Healing rates, complications, preoperative and postoperative pure-tone average (PTA) and air-bone gap (ABG) were analyzed. Results At six months follow-up, the healing rate of tympanic membrane was 100% (80/80). The mean preoperative pure-tone average (PTA)（43.18± 14.57 dB HL）significantly decreased (27.08±9.36 dB HL) six months after the operation (P=0.002). Similarly, the mean preoperative ABG（19.05±5.72 dB HL）reduced to（9.36±3.75 dB HL） (P=0.0019) at sixth month. Major complications were not observed during follow-up. Conclusions The usage of an extra patch during endoscopic cartilage myringoplasty for large, subtotal and marginal tympanic membrane perforations achieved a high healing rate and a statistically significant hearing gain with low incidence of complications.

No abstract