Endoscopic Lateral Cartilage Graft Tympanoplasty

Area of Science:

• Otolaryngology
• Surgical Innovation
• Auditory Health

Background:

• Tympanic membrane perforations present challenges for traditional medial graft techniques, especially with extensive myringitis or unfavorable perforation characteristics.
• Existing methods may not be optimal for all patient demographics and perforation types, necessitating alternative surgical approaches.

Purpose of the Study:

• To describe and evaluate a novel transcanal endoscopic lateral cartilage graft tympanoplasty technique.
• To assess the feasibility, efficacy, and initial outcomes of this technique in pediatric and adult patients.

Main Methods:

• A case series involving chart review of 31 patients (34 ears) with tympanic membrane perforations unsuitable for medial grafting.
• Utilized a transcanal endoscopic approach with a bisected tragal cartilage-perichondrium shield graft.
• Follow-up included audiological assessment and evaluation of perforation closure.

Main Results:

• Successful closure was achieved in 97.1% of cases after initial and revision surgeries.
• Significant improvements were observed in pure-tone average (11.5 dB) and air-bone gap (11.4 dB).
• 79% of patients achieved an air-bone gap closure within 20 dB.

Conclusions:

• Transcanal endoscopic lateral cartilage graft tympanoplasty is a feasible and effective technique for managing challenging tympanic membrane perforations.
• Initial results indicate favorable outcomes regarding graft success and hearing improvement.
• Further research is warranted to compare long-term efficacy against other tympanoplasty methods.