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Endoscopic tympanoplasty type I using interlay technique.

Masahiro Takahashi1, Masaomi Motegi2, Kazuhisa Yamamoto2

  • 1Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan. takahashima@jikei.ac.jp.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|November 18, 2022
PubMed
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The interlay technique is effective for endoscopic tympanoplasty, achieving a 98% closure rate for tympanic perforations. This endoscopic approach offers comparable success to microscopic surgery for tympanic membrane repair.

Area of Science:

  • Otolaryngology
  • Endoscopic Ear Surgery
  • Tympanoplasty Techniques

Background:

  • The interlay technique for tympanoplasty is infrequently reported in transcanal endoscopic ear surgery compared to the underlay technique.
  • Challenges in epithelial layer detachment with one hand in endoscopic surgery have limited interlay technique adoption.
  • Focusing on anteroinferior visibility and utilizing the inferior tympanic membrane for epithelial detachment are key for endoscopic interlay tympanoplasty.

Discussion:

  • The study retrospectively analyzed 51 patients undergoing endoscopic tympanoplasty using the interlay technique.
  • Outcomes were compared to 104 patients who underwent microscopic surgery (MS) with the underlay technique.
  • Both surgical success rates for tympanic membrane perforation repair and postoperative hearing outcomes were assessed over one year.
Keywords:
Chronic otitis mediaInterlay techniqueMiddle ear surgeryMyringoplastyTranscanal endoscopic ear surgeryTympanic perforations

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Key Insights:

  • Endoscopic interlay tympanoplasty achieved a high perforation closure rate (98.0%) with good postoperative hearing (average air-bone gap of 6.8 dB).
  • The surgical success rate for perforation repair was comparable to the microscopic surgery group (93.3%).
  • The average postoperative air-bone gap was significantly better in the endoscopic interlay group than in the microscopic underlay group (P < 0.01).

Outlook:

  • The interlay technique should be considered a viable option for endoscopic surgery in treating tympanic perforations.
  • Further research is needed to optimize postoperative outcomes and establish this technique as a standard procedure.
  • Continued investigation into endoscopic tympanoplasty techniques can enhance treatment efficacy for tympanic membrane perforations.