Endoscopic transcanal myringoplasty for tympanic perforations: An outpatient minimally invasive procedure

Chih Chieh Tseng, Ming Tang Lai, Chia Che Wu, Sheng Po Yuan, Yi Fang Ding

Research output: Contribution to journalArticle

Abstract

Objective: Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty). Methods: We retrospectively reviewed the medical records of patients who underwent endoscopic transcanal myringoplasty for perforations of the tympanic membrane. The main outcome was the overall rate of graft success of endoscopic transcanal myringoplasty. Results: A total of 181 patients were included in the analysis. The overall graft success was determined in 163 of 181 patients (92.8%). The mean preoperative and postoperative air-bone gaps were 19.3. dB and 7.8. dB, respectively, revealing a significant improvement of 11.5. dB (Cohen's d, 1.27; 95% CI, 1.03-1.50; P< 0.05; paired t test) in the air-bone gap. The rate of graft success with partial visualization of the perforation margin was comparable to that with complete visualization of the perforation margin. Larger sizes of perforations were significantly associated with lower rates of graft success (P <. 0.01). Conclusion: Our study revealed that the rate of graft success and hearing results of endoscopic transcanal myringoplasty and microscopic myringoplasty are comparable for repairing perforations of the tympanic membrane. Visualization of the perforation margin by otoscopy did not affect the rate of graft success. However, endoscopic transcanal myringoplasty is less invasive because this technique does not require postauricular incision, canalplasty, and general anesthesia.

Original languageEnglish
JournalAuris Nasus Larynx
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Myringoplasty
Outpatients
Transplants
Tympanic Membrane Perforation
Otoscopy
Air
Bone and Bones
Tympanic Membrane
General Anesthesia
Hearing
Medical Records

Keywords

  • Endoscope
  • Myringoplasty
  • Perforation
  • Transcanal
  • Tympanic membrane

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Endoscopic transcanal myringoplasty for tympanic perforations : An outpatient minimally invasive procedure. / Tseng, Chih Chieh; Lai, Ming Tang; Wu, Chia Che; Yuan, Sheng Po; Ding, Yi Fang.

In: Auris Nasus Larynx, 2017.

Research output: Contribution to journalArticle

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abstract = "Objective: Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty). Methods: We retrospectively reviewed the medical records of patients who underwent endoscopic transcanal myringoplasty for perforations of the tympanic membrane. The main outcome was the overall rate of graft success of endoscopic transcanal myringoplasty. Results: A total of 181 patients were included in the analysis. The overall graft success was determined in 163 of 181 patients (92.8{\%}). The mean preoperative and postoperative air-bone gaps were 19.3. dB and 7.8. dB, respectively, revealing a significant improvement of 11.5. dB (Cohen's d, 1.27; 95{\%} CI, 1.03-1.50; P< 0.05; paired t test) in the air-bone gap. The rate of graft success with partial visualization of the perforation margin was comparable to that with complete visualization of the perforation margin. Larger sizes of perforations were significantly associated with lower rates of graft success (P <. 0.01). Conclusion: Our study revealed that the rate of graft success and hearing results of endoscopic transcanal myringoplasty and microscopic myringoplasty are comparable for repairing perforations of the tympanic membrane. Visualization of the perforation margin by otoscopy did not affect the rate of graft success. However, endoscopic transcanal myringoplasty is less invasive because this technique does not require postauricular incision, canalplasty, and general anesthesia.",
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AU - Ding, Yi Fang

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N2 - Objective: Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty). Methods: We retrospectively reviewed the medical records of patients who underwent endoscopic transcanal myringoplasty for perforations of the tympanic membrane. The main outcome was the overall rate of graft success of endoscopic transcanal myringoplasty. Results: A total of 181 patients were included in the analysis. The overall graft success was determined in 163 of 181 patients (92.8%). The mean preoperative and postoperative air-bone gaps were 19.3. dB and 7.8. dB, respectively, revealing a significant improvement of 11.5. dB (Cohen's d, 1.27; 95% CI, 1.03-1.50; P< 0.05; paired t test) in the air-bone gap. The rate of graft success with partial visualization of the perforation margin was comparable to that with complete visualization of the perforation margin. Larger sizes of perforations were significantly associated with lower rates of graft success (P <. 0.01). Conclusion: Our study revealed that the rate of graft success and hearing results of endoscopic transcanal myringoplasty and microscopic myringoplasty are comparable for repairing perforations of the tympanic membrane. Visualization of the perforation margin by otoscopy did not affect the rate of graft success. However, endoscopic transcanal myringoplasty is less invasive because this technique does not require postauricular incision, canalplasty, and general anesthesia.

AB - Objective: Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty). Methods: We retrospectively reviewed the medical records of patients who underwent endoscopic transcanal myringoplasty for perforations of the tympanic membrane. The main outcome was the overall rate of graft success of endoscopic transcanal myringoplasty. Results: A total of 181 patients were included in the analysis. The overall graft success was determined in 163 of 181 patients (92.8%). The mean preoperative and postoperative air-bone gaps were 19.3. dB and 7.8. dB, respectively, revealing a significant improvement of 11.5. dB (Cohen's d, 1.27; 95% CI, 1.03-1.50; P< 0.05; paired t test) in the air-bone gap. The rate of graft success with partial visualization of the perforation margin was comparable to that with complete visualization of the perforation margin. Larger sizes of perforations were significantly associated with lower rates of graft success (P <. 0.01). Conclusion: Our study revealed that the rate of graft success and hearing results of endoscopic transcanal myringoplasty and microscopic myringoplasty are comparable for repairing perforations of the tympanic membrane. Visualization of the perforation margin by otoscopy did not affect the rate of graft success. However, endoscopic transcanal myringoplasty is less invasive because this technique does not require postauricular incision, canalplasty, and general anesthesia.

KW - Endoscope

KW - Myringoplasty

KW - Perforation

KW - Transcanal

KW - Tympanic membrane

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