Endoscopic transcanal myringoplasty for anterior tympanic membrane perforation

Ayache, S.; Beltran, M.; Guevara, N.

doi:10.1016/j.anorl.2019.05.001

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…13-15 Endoscopy has played an increasingly important role in otology over the past several years. 9-13,15 Endoscopy provides a wider surgical view and allows clear observation of the whole perforation edges and middle ear structure, which can avoid postauricular incision and canalplasty through the narrow EAC. However, elevation of a tympanomeatal flap via incision of the EAC is needed to cover the temporal fascia or perichondrium graft, and thereby promotes stabilization of the graft in the vast majority of anterior perforations regardless of endoscopic or microscopic technique.…”

Section: Discussionmentioning

confidence: 99%

“…However, elevation of a tympanomeatal flap via incision of the EAC is needed to cover the temporal fascia or perichondrium graft, and thereby promotes stabilization of the graft in the vast majority of anterior perforations regardless of endoscopic or microscopic technique. 9-13,15 Some groups reported that tympanoplasty using the tympanomeatal flap elevation technique has a higher graft take rate than transtympanic myringoplasty. 16,17…”

Section: Discussionmentioning

confidence: 99%

“…8 In addition, elevation of the tympanomeatal flap and tunnel via incision of the external auditory canal (EAC) has been performed in many cases of anterior marginal perforation, with subsequent placement of the perichondrium or fascia graft medially under the tympanomeatal flap to strengthen the graft. 9-11 There have been few reports describing endoscopic myringoplasty with elevation of a tympanomeatal flap without incision of the EAC for the repair of an anterior perforation. The present study was performed to evaluate the rate of graft success and hearing outcomes in cases of endoscopic myringoplasty with elevation of the tympanomeatal flap without incision of the EAC in the repair of an anterior perforation.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations

Lou¹

2020

Ann Otol Rhinol Laryngol

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Objective: We evaluated the graft take rate and hearing gain of endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap for repairing an anterior tympanic membrane perforation. Study design: A retrospective case series Setting: Tertiary university hospital Materials and Methods: The study population consisted of patients with an anterior perforation undergoing endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap. The primary outcome was the graft take rate at 6 months. The secondary outcomes were the air–bone gap (ABG) gain at 3 months and complications. Results: A total of 51 patients with a unilateral anterior marginal perforation were included in this study. The mean operation time was 62.2 ± 8.3 minutes. The graft success rate was 92.2% (47/51) at 6 months. The mean preoperative ABG was 28.07 ± 5.13 dB, while the mean postoperative ABG was 12.24 ± 4.89 dB ( P < .05). No patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus. Two patients with a middle perforation developed postoperative purulent otorrhea that resulted in residual perforations. The cartilage graft was extruded into the anterior annulus in two patients with large perforations that resulted in graft lateralization in one patient and residual perforation in the other. Conclusions: Endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap is a useful procedure with a low reperforation rate for repairing anterior perforation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations

Lou¹

2020

Ann Otol Rhinol Laryngol

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“…Usually, the most challenging TM perforations for myringoplasty are the marginal perforations because of access difficulty and lack of support to the graft. TFE and creation of a tunnel are essential to improve graft stability in most cases [19][20][21]. In this study, however, we applied endoscopic cartilage myringoplasty with the removal of a small rim of the EAC to repair the marginal perforations.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal to repair marginal perforations

Lou¹

2020

Journal of Otolaryngology - Head & Neck Surgery

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Objective: To evaluate the graft success rate and postoperative hearing gain for marginal perforations using endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal (EAC). Study design: Prospective case series. Materials and methods: We performed a prospective study in 41 patients with marginal perforations who underwent endoscopic cartilage myringoplasty with the removal of a small rim of EAC. Patients were followed up for 6 months. Results: Of the 41 patients with unilateral marginal perforation included in this study, the graft success rate was 100% (41/41). The mean ABG improved from 11.31 ± 9.71 dB preoperatively to 7.31 ± 2.32 dB postoperatively for small-and medium-sized perforations (P = 0.13); the mean ABG improved from 21.46 ± 8.39 dB preoperatively to 9.84 ± 2.41 dB postoperatively for large perforations (P < 0.05); the mean ABG improved from 28.79 ± 6.74 dB preoperatively to 10.13 ± 3.56 dB postoperatively for subtotal and total perforations (P < 0.05). There were no cases of graft lateralization or significant blunting or atelectasis or graft adhesions. Three patients developed postoperative otorrhoea and five patients had mild myringitis. Conclusions: Endoscopic cartilage myringoplasty with the removal of a small rim of the EAC is simple and feasible, showing a high graft success rate and minimal complications for repairing marginal perforations.

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“…Otolojik cerrahi pratiğinde, endoskopik yaklaşım mikroskopik yaklaşımla karşılaştırıldığında tek elle çalışma, kanama ve buğulanmaya bağlı görüntüde bozulma ve uzamış öğrenme eğrisi gibi bazı dezavantajlara sahiptir (8,9,14). Düşük ve stabil preoperatif ve intra-operatif arteryel kan basıncı, dış kulak yoluna lokal anestezik ajan infiltrasyonu ve endoskopik kulak cerrahisi için modifiye edilmiş aspirasyon fonksiyonlu otolojik cerrahi aletlerin kullanımı gibi bazı yaklaşımlarla endoskopik kulak cerrahi sırasında karşılaşılabilen ve ameliyat süresini uzatan kanamalar önlenebilir (13,15). Literatürdeki çalışmalara bakıldığında, TM anterior perforasyonu olan hastalarda yapılan endoskopik transkanal timpanoplastilerin ortalama ameliyat süreleri 37-66.1 dakika arasında değişmektedir (5,16).…”

Section: Discussionunclassified

Our Results of Endoscopic Cartilage Tympanoplasty in Patients with Tympanic Membrane Anterior Perforation

Gülşen¹,

Çikrikci²

2020

Harran Üniversitesi Tıp Fakültesi Dergisi

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Birçok greftleme tekniği ve cerrahi yaklaşım tanımlanmasına rağmen timpanik membran anterior kadran perforasyonlarının onarımı teknik olarak kulak burun boğaz uzmanları için zorlayıcıdır. Bu çalışmada, timpanik membran anterior kadran perforasyonlarının onarımında endoskopik kıkırdak timpanoplastinin cerrahi ve fonksiyonel sonuçlarının değerlendirilmesi amaçlanmıştır. Materyal ve metod: 1 Ocak 2015-30 Nisan 2019 tarihleri arasında anterior kadran perforasyonu olan ve transkanal endoskopik Tip 1 kıkırdak timpanoplasti yapılan 34 hasta çalışmaya alındı. Bu hastaların greft başarısı, odyolojik verileri ve komplikasyonlar geriye dönük olarak incelendi. Kemikçik zincir rekonstrüksiyonu yapılan, kolesteatomu olan veya takiplerine düzenli gelmeyen hastalar ve timpanik membran perforasyonu anterior kadranda olmayan hastalar çalışma dışı bırakıldı. Bulgular: Endoskopik transkanal kıkırdak timpanoplasti yapılan 34 hastanın tıbbi kayıtları incelendi. 15 erkek (%44,1) ve 19 kadın (%55,9) hasta vardı. Ortalama yaş 35,44 ± 9,84'dü. Hastaların 15'i sağ kulak (%44,1), 19'u sol kulaktan (%55,9) ameliyat oldu. Ortalama ameliyat süresi 31,56 ± 4,04 dakikaydı. Greft başarı oranları postoperatif 3. Ayda %94,1 ve postoperatif 6. Ayda %91,2 idi. Ameliyat sonrası altıncı ayda yapılan saf ses odyometri ölçümlerine göre postoperatif hava-kemik aralığı değerleri, preoperatif değerlere göre istatistiksel olarak anlamlı derecede düzeldi (p<0,001). Sonuç: Endoskopik transkanal Tip 1 kıkırdak timpanoplasti timpanik membran anterior perforasyonlarını onarmak için minimal invaziv, etkili ve güvenilir bir cerrahi tedavi seçeneğidir.

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Endoscopic transcanal myringoplasty for anterior tympanic membrane perforation

Cited by 9 publications

References 10 publications

Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations

Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations

Endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal to repair marginal perforations

Our Results of Endoscopic Cartilage Tympanoplasty in Patients with Tympanic Membrane Anterior Perforation

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