Preliminary outcomes of endoscopic middle-ear surgery in 103 cases: a UK experience

Yiannakis, Constantina; Sproat, Rhona; Iyer, Arunachalam

doi:10.1017/s0022215118000695

Cited by 20 publications

(23 citation statements)

References 9 publications

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“…‡ Success rates for TM closure were 69% to 100% (median, 88%). 4,5,7,9-16,24-36,38 Similar results were obtained from the data of the current study.…”

Section: Discussionsupporting

confidence: 90%

Endoscopic Type 1 Tympanoplasty in Chronic Otitis Media: Comparative Study with a Postauricular Microscopic Approach

Ohki

Kikuchi

Tanaka

2019

Otolaryngol.--head neck surg.

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Objective To compare surgical outcomes after tympanoplasty without ossiculoplasty for chronic otitis media between transcanal endoscopic ear surgery (TEES) and postauricular microscopic ear surgery (PAMES). Study Design Case-control study. Setting Tertiary care university hospital. Subjects and Methods Consecutive patients ( N = 122) who had undergone tympanoplasty without ossiculoplasty for chronic otitis media were enrolled in this retrospective study and divided into 2 groups: TEES (n = 47) and PAMES (n = 75). Middle ear condition was graded with the middle ear risk index. Hearing, repair of tympanic membrane perforation, and surgical time were assessed. Results The surgical success rate for hearing (air-bone gap ≤20 dB) was 95.7% in the TEES group and 84.0% in the PAMES group. Lower middle ear risk resulted in similar mean (95% CI) closure of air-bone gaps (TEES: 9.6, 6.5-12.6; PAMES: 8.0, 6.4-9.7; P = .333), whereas higher middle ear risk demonstrated significantly larger closure of air-bone gaps for the TEES group (10.1, 3.3-16.9) than the PAMES group (–0.2, –4.5 to 4.2; P = .009). The surgical success rate for repair of tympanic membrane perforation and surgical time were equivalent between TEES and PAMES. Conclusion Under favorable conditions of the middle ear, TEES and PAMES resulted in similar hearing improvement by tympanoplasty without ossiculoplasty. However, under adverse conditions of the middle ear, TEES was a more beneficial approach for hearing improvement than PAMES.

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“…‡ Success rates for TM closure were 69% to 100% (median, 88%). 4,5,7,9-16,24-36,38 Similar results were obtained from the data of the current study.…”

Section: Discussionsupporting

confidence: 90%

Endoscopic Type 1 Tympanoplasty in Chronic Otitis Media: Comparative Study with a Postauricular Microscopic Approach

Ohki

Kikuchi

Tanaka

2019

Otolaryngol.--head neck surg.

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“…6 The combination of thin rigid otoendoscopes and full highdefinition camera systems has brought about a less-invasive transcanal approach to the middle ear with clear and high contrast views. 7 Transcanal endoscopic ear surgery (TEES) provides a wider view of the surgical field, increased visibility around target objects, and less hidden space. Tympanoplasty (myringoplasty) is a standard surgical procedure used to repair the tympanic membrane (TM) and improve hearing status.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Functional Success of Fat Myringoplasty and Perifascial Areolar Tympanoplasty in Transcanal Endoscopic Ear Surgery

Yang

et al. 2020

Ear Nose Throat J

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Objectives: We compared the functional outcomes of fat myringoplasty and areolar tympanoplasty through a small postauricular incision in patients who underwent transcanal endoscopic ear surgery (TEES). Methods: The study included patients who underwent myringoplasty or type I tympanoplasty using TEES in our Department of Otolaryngology between April 2016 and May 2019. The patients were divided into 2 groups according to the type of graft material used, which was selected based on the available amount of subcutaneous fat and the surgeon’s experience. Results: In total, 63 patients received fat tissue grafts (group A) and 77 received areolar tissue grafts (group B). The median operative time was significantly longer in group B (132 minutes) than in group A (65 minutes); perforations were significantly larger in group B than in group A (61.0% vs 29.7% of the eardrum surface). The postoperative air conduction threshold, air–bone gap, and speech reception threshold values were significantly lower than the preoperative values in both groups. The graft success rate did not significantly differ between groups A (96.8%, 61/63) and B (96.1%, 74/77). In group A, the perforation was > 35% of the eardrum surface in 27.0% (17/63) of the patients; the graft success rate was 100% (17/17). In the remaining 46 patients (perforation > 35%), the graft success rate was 95.7% (44/46); this difference was not statistically significant. Conclusions: Transcanal endoscopic ear surgery increases the usefulness of fat myringoplasty for the repair of perforations > 35% of the eardrum surface. Postauricular fatty and areolar tissues are suitable for this simple and rapid technique, which yields excellent outcomes.

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“…Comparing our results with the studies of Marchioni et al and Yiannakis et al reveals our complication rate to be higher. 8,10 A possible explanation is the small number of cases used in our study (compared with 825 cases used by Marchioni et al and the 103 cases used by Yiannakis et al).…”

Section: Discussionmentioning

confidence: 71%

“…6 Although Kanona et al reported a significant air bone gap improvement with EES compared with traditional methods, 7 this result could not be replicated in a subsequent study. 8 Limitations of TEES have been discussed in the literature in order to refine this surgical technique. Swarup et al found most otologists expressed the need for better instruments in EES to improve the view of the difficult areas in the middle ear and to remove cholesteatomas, 9 arising from the onehanded method during TEES.…”

Section: Introductionmentioning

confidence: 99%

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The first Malaysian experience on totally endoscopic ear surgery

Misron

Kamalden

2019

Proceedings of Singapore Healthcare

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Introduction: Totally endoscopic ear surgery (TEES) is defined as exclusive application of endoscope transcanally in otologic surgery. This study is aimed to highlight indications and ear pathologies for TEES. In addition, intraoperative, early postoperative and delayed postoperative complications of TEES will be also described in this study. Methodology: This is a retrospective study of TEES performed by a single experienced and trained otologist in endoscopic ear surgery in a single institution between 1 July 2014 and 31 June 2018. A total of 43 patients were recruited in this study. Sociodemographic information, indications for TEES, ear pathologies, type of surgery performed and complications of TEES were analyzed. Results: The indications for TEES comprised middle ear lesion (65.1%), followed by second look surgery (14.0%), external auditory canal lesion (11.6%) and internal acoustic meatus lesion and surgery for conductive hearing loss which were 4.7%. Various external auditory canal pathologies encountered for TEES were ear canal osteoma (4.7%), acquired ear canal stenosis (2.3%) and tumor (4.7%). Regarding middle ear pathologies, limited atticoantral cholesteatoma accounted for most of the cases, 46.5%. Other middle ear lesions included adhesive otitis media (14.0%), recurrent cholesteatoma (14.0%), tumor (4.7%), otosclerosis (2.3%) and ossicular discontinuity (2.3%). Internal acoustic meatus lesion constituted 4.7% of cases. Some 4.7% of cases developed intraoperative complications, while early and delayed complications were 7.0%. Conclusion: TEES is a feasible surgical technique for diverse ear pathologies in the otologic specialty. It is also proven to be safe with good surgical outcomes.

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Preliminary outcomes of endoscopic middle-ear surgery in 103 cases: a UK experience

Abstract: Our results confirm that endoscopic middle-ear surgery is safe, and the short-term outcomes are comparable with conventional surgery.

Cited by 20 publications

References 9 publications

Endoscopic Type 1 Tympanoplasty in Chronic Otitis Media: Comparative Study with a Postauricular Microscopic Approach

Endoscopic Type 1 Tympanoplasty in Chronic Otitis Media: Comparative Study with a Postauricular Microscopic Approach

Comparison of the Functional Success of Fat Myringoplasty and Perifascial Areolar Tympanoplasty in Transcanal Endoscopic Ear Surgery

The first Malaysian experience on totally endoscopic ear surgery

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