Endoscopic permeatal “push-through” myringoplasty: hearing gain and graft uptake

Abstract

Background Endoscopic myringoplasty allows full visualization of the external ear canal, tympanic membrane, and middle ear without the need to reposition the patient’s head. The endoscope allows accessing hidden areas and structures not properly viewed by the microscope such as sinus tympani, facial recess, and hypotympanum. It also provides sharp, magnified image and shortens the duration of the surgery. The postoperative pain and morbidity are reduced and hence the hospital stay. The aim of this work was to evaluate the efficacy of the endoscopic-assisted permeatal transperforation “push-through” myringoplasty by assessing the graft take rate and hearing results. Our study included twenty patients (14 females and 6 males) with chronic suppurative otitis media without cholesteatoma that underwent endoscopic-assisted permeatal transperforation myringoplasty. Results The case was considered '”successful'” if there was complete healing of the tympanic membrane and improvement of hearing. Graft uptake success rates were 85% with P-value 0.132. Average air-bone gap (A-B gap) preoperative was 18.20 dB; average A-B gap 1-month postoperative was 7.75 dB. Conclusion Endoscopic transcanal myringoplasty provided sharp, magnified visualization and operability as it avoids retroauricular skin incision and minimizes surgical procedures to expose hidden areas. There is less bleeding, a shorter operating time, less postoperative morbidity, and minimal postoperative care.

An Investigation on the Fibrin Glue's Impact on Myringoplasty's Success Rate: A Randomized Controlled Study

“…When platelet-rich fibrin was employed, the rate of postoperative graft uptake was higher. The same group also had a decreased post-operative infection rate (17,18) .…”

“…According to this research, the PRF Plug Myringoplasty procedure had a 92% closure rate for traumatic tympanic membrane perforations, whereas TCA had a 50% closure rate. There was also a statistically significant improvement in hearing (88%) (18) . Another investigation applied a thin layer of fibrin glue to the perforation's lateral border.…”