Endoscopic revision tympanoplasties: our experience

Abstract

Objective: The aim of this study was to analyze the outcomes and complications of endoscopic tympanoplasties and review the strategies for endoscopic revision surgeries. Methods: Revision endoscopic surgeries are performed on patients with unsatisfactory outcomes after endoscopic tympanoplasties. This study was approved by the Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China (approval No. 2020-0045-1). Results: Residual or recurrent tympanic membrane marginal perforation is treated by autogenous fat and cartilage grafting; graft collapse is treated using tissue from the tragus; and graft displacement is treated by endoscopic fixation of the cartilage–perichondrium complex. Lateral healing of the tympanic membrane, prosthesis fracture, prosthesis extrusion, middle ear adhesions, and recurrent perforation also required revision surgeries. Conclusion: Residual or recurrent tympanic membrane marginal perforation is the most common cause of unsatisfactory outcomes after endoscopic tympanoplasty; fat grafting is effective only for small perforations. Small cartilage grafts are an effective means of dealing with residual marginal perforation; the cartilage and perichondrium complex should be fixed securely. Patients with prosthesis implants require regular examination.