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Updated: Oct 23, 2025
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Endoscopic transtympanic cartilage push-through myringoplasty without tympanomeatal flap elevation for tympanic
Fengming Gu1,2
1Department of Otology and Skull Base Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China.
Background:
The elevation of the tympanomeatal flap in endoscopic myringoplasty will cause considerable tissue damage.
Objective:
To analyze anatomic and audiological results of tympanic membrane perforation underwent endoscopic transtympanic cartilage push-through myringoplasty without tympanomeatal flap elevation (EPM) and their relationship with the size of perforation.
Methods:
A clinical retrospective study was performed on 75 cases of tympanic membrane perforation that underwent EPM from January 2019 to March 2021. Graft success and hearing outcomes were evaluated 3 months after surgery.
Results:
The overall graft success rate for EPM was 94.7% (71/75). The total rate of hearing success, postoperative ABG ≤ 20 dB was achieved in 96.0% (72/75). The overall mean AC threshold of 35.1 ± 5.6 dB was lowered to 25.0 ± 4.8 dB postoperatively (p < .01). The mean pre- and postoperative ABG of all patients were 20.5 ± 4.6 dB and 10.4 ± 3.9 dB (p < .01), respectively. The graft success rates for the small, middle and large perforations groups were 100% (11/11), 100% (34/34) and 86.7% (26/30), respectively.
Conclusion:
It is revealed that EPM is an effective method to repair perforation of tympanic membrane. The size of the tympanic membrane perforation may be a risk factor for perforation healing and hearing recovery, although EPM is available for large perforations.
