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Published on: January 26, 2024
Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane
D E M El-Hennawi1, M R Ahmed1, A S Abou-Halawa1
1Otolaryngology Department,Faculty of Medicine,Suez Canal University,Ismailia,Egypt.
Background:
Microscopic myringoplasty is the most frequently performed procedure for repairing tympanic membrane perforations. The endoscopic transcanal approach bypasses the narrow ear canal segment and provides a wider view.
Methods:
An open-label randomised clinical trial was conducted on 56 patients with small anterior tympanic membrane perforations. Perforations were repaired with an endoscopic push-through technique (n = 28) or a microscopic underlay technique (n = 28). Follow up was conducted using endoscopic examination and pure tone audiometry three months' post-operatively.
Results:
Graft success rate was 92.9 per cent in the endoscopic group versus 85.7 per cent in the microscopic group. The corresponding pre-operative mean air-bone gaps were 17.4 dB and 18.5 dB, improving to 6.1 dB and 9.3 dB post-operatively (p > 0.05). Mean air-bone gap closure was 11.4 dB in the endoscopic group and 9.2 dB in the microscopic group (p > 0.05). Mean operative time and estimated blood loss were 37.0 minutes and 29 ml in the endoscopic group, versus 107 minutes and 153 ml in the microscopic group (both p < 0.05).
Conclusion:
The endoscopic push-through technique for anterior tympanic membrane perforations is as effective as microscopic underlay myringoplasty; furthermore, it is less invasive and takes less operative time.
Insights
Endoscopic myringoplasty offers comparable graft success to microscopic repair for tympanic membrane perforations. This endoscopic push-through technique is less invasive and requires less operative time.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Medical Technology
Background:
- Microscopic myringoplasty is standard for tympanic membrane perforations.
- Endoscopic transcanal approach offers a wider view and bypasses narrow ear canals.
Purpose of the Study:
- To compare the efficacy and invasiveness of endoscopic push-through versus microscopic underlay myringoplasty for anterior perforations.
Main Methods:
- An open-label randomized clinical trial involved 56 patients with small anterior tympanic membrane perforations.
- Patients underwent either endoscopic push-through (n=28) or microscopic underlay (n=28) repair.
- Outcomes were assessed via endoscopic examination and audiometry at three months post-operation.
Main Results:
- Graft success rates were 92.9% (endoscopic) vs. 85.7% (microscopic).
- Mean operative time (37.0 vs. 107 minutes) and blood loss (29 vs. 153 ml) were significantly lower in the endoscopic group (p < 0.05).
- Both techniques showed significant improvement in air-bone gaps, with no statistically significant difference between groups.
Conclusions:
- Endoscopic push-through myringoplasty is as effective as microscopic underlay myringoplasty for anterior tympanic membrane perforations.
- The endoscopic technique is less invasive and associated with reduced operative time and blood loss.
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