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Transcanal Endoscopic Type 1 Cartilage Tympanoplasty in Children
Doğukan Özdemir1, Abdulkadir Özgür1, Gökhan Akgül1
1Department of Otorhinolaryngology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey.
Insights
Transcanal endoscopic type 1 tympanoplasty using cartilage grafts is a safe and effective minimally invasive procedure for pediatric chronic otitis media. This technique offers excellent graft success and significant hearing improvement, regardless of perforation size or location.
Area of Science:
- Otolaryngology
- Minimally Invasive Surgery
- Pediatric Otology
Background:
- Transcanal endoscopic type 1 tympanoplasty offers superior visualization in deep and narrow ear spaces compared to traditional microscopic methods.
- Cartilage grafts are increasingly utilized for tympanoplasty due to their durability and availability.
Purpose of the Study:
- To evaluate the efficacy of transcanal endoscopic type 1 cartilage tympanoplasty in pediatric patients.
- To assess outcomes based on perforation size and location, including air-bone gap difference, graft success, and hearing gain.
Main Methods:
- A prospective study included 50 pediatric patients with chronic otitis media undergoing transcanal endoscopic type 1 cartilage tympanoplasty.
- Tragal cartilage grafts were used in all cases. Audiometric evaluations (500-4000 Hz), air-bone gap measurements, and graft success rates were analyzed.
Main Results:
- The overall graft success rate was 94% (47/50 patients).
- Significant improvements in mean hearing levels across all tested frequencies (p<0.001) and air-bone gap closure (p<0.001) were observed by the 6th postoperative month.
- Mean operative time was 43.34±8.56 minutes.
Conclusions:
- Transcanal endoscopic type 1 cartilage tympanoplasty is a safe, minimally traumatic, and effective procedure for pediatric patients.
- This technique achieves high rates of anatomic and functional recovery with optimal surgery duration, irrespective of perforation characteristics.
Objective:
Transcanal endoscopic type 1 tympanoplasty is a minimally invasive procedure that enables better visualization of deep and narrow spaces compared to conventional microscopic methods. In our study, we aimed to evaluate air-bone gap difference, graft success, and hearing gain according to the perforation size and location in pediatric patients who underwent transcanal endoscopic type 1 cartilage tympanoplasty.
Methods:
Fifty pediatric patients who underwent transcanal endoscopic type 1 cartilage tympanoplasty for chronic otitis media were included in the study. Tragal cartilage grafts were used in all patients. Air conduction pure tone audiometry hearing results (500, 1000, 2000, and 4000 Hz), mean air-bone gap levels, operating times, postoperative gap closure, and graft success rates were evaluated.
Results:
Mean operating time was 43.34±8.56 minutes. Overall graft success was 94% (47/50). Mean hearing levels at all frequencies (500, 1000, 2000, and 4000 Hz) were found to have significantly improved after the operation (p<0.001). Mean preoperative air conduction pure tone threshold and mean air-bone gap had statistically significantly improved by the 6th postoperative month (p<0.001).
Conclusion:
Transcanal endoscopic type 1 cartilage tympanoplasty was found to be a minimally traumatic, easy and safe method with a low complication rate. In pediatric patients, this method allows for high rates of anatomic and functional recovery with optimal surgery time regardless of the location and the size of the perforation.
