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Endoscopic tympanoplasty with post-conchal perichondrium in repairing large-sized eardrum perforations
Chin-Kuo Chen1,2,3, Hsin-Chiao Hsu4,5, Min Wang4,5
1Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. dr.chenck@gmail.com.
Summary
Endoscopic tympanoplasty using post-conchal perichondrium (PCP) offers a reliable and fascia-preserving option for large eardrum perforations, demonstrating excellent outcomes and shorter operation times compared to microscopic techniques.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Regenerative Medicine
Background:
- Large eardrum perforations present a significant reconstructive challenge.
- Traditional microscopic tympanoplasty often utilizes temporalis fascia grafts.
- Exploring alternative techniques for improved outcomes is crucial.
Purpose of the Study:
- To compare the efficacy of endoscopic tympanoplasty with post-conchal perichondrium (PCP) versus microscopic tympanoplasty with temporalis fascia.
- To evaluate graft success, audiological results, and postoperative pain in repairing large eardrum perforations.
Main Methods:
- Retrospective chart review of 43 patients with large eardrum perforations undergoing type 1 tympanoplasty.
- Two groups: endoscopic tympanoplasty with PCP (n=22) and microscopic tympanoplasty with temporalis fascia (n=21).
- Comparison of graft success, audiometric data (PTA, WRS, ABG), operation time, and pain scores.
Main Results:
- Graft success rates were comparable: 86.3% (endoscopic) vs. 85.7% (microscopic).
- Endoscopic tympanoplasty showed significantly shorter mean operation time (79.8 min vs. 99.9 min).
- Both techniques improved hearing, with endoscopic approach showing greater air-bone gap closure at 1000 and 2000 Hz.
Conclusions:
- Endoscopic tympanoplasty with PCP is a reliable and effective method for large eardrum perforations.
- This technique preserves fascia and yields excellent surgical outcomes.
- Endoscopic approach offers advantages in terms of operative time and hearing improvement.
