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Endoscopic Double Flap Tympanoplasty.

Shafaat Ahmad1, Ravi Meher1, Praveen Kumar Rathore1

  • 1Department of Otorhinolaryngology and Head & Neck Surgery, Maulana Azad Medical College and associated Lok Nayak Hospital, G.B Pant Hospital, New Delhi, 110002 India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|October 8, 2024
PubMed
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Endoscopic single flap tympanoplasty (ESFT) and endoscopic double flap tympanoplasty (EDFT) showed similar graft success and hearing improvement for large eardrum perforations. Further research with larger sample sizes is needed to confirm these findings.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Medical Technology

Background:

  • Large tympanic membrane (TM) perforations with limited anterior remnant pose surgical challenges.
  • Endoscopic tympanoplasty offers minimally invasive repair options.
  • Comparing different endoscopic techniques is crucial for optimizing outcomes.

Purpose of the Study:

  • To compare the graft uptake and hearing results of endoscopic single flap tympanoplasty (ESFT) versus endoscopic double flap tympanoplasty (EDFT).
  • To evaluate the efficacy of two endoscopic tympanoplasty techniques for large TM perforations.

Main Methods:

  • A randomized controlled trial involving 40 patients with large TM perforations.
  • Patients were assigned to either ESFT or EDFT groups (20 per group).
Keywords:
Conductive Hearing lossEndoscopyMethodsTympanic Membrane PerforationTympanoplasty

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  • Temporalis fascia grafts were used in both groups, with outcomes assessed via graft success rate and hearing improvement (air-bone gap).

    • Main Results:

    • Graft success rates were 85% for ESFT and 90% for EDFT.
    • Median air-bone gap improvement was 5 dB for ESFT and 8.75 dB for EDFT.
    • No statistically significant difference was observed in graft success or hearing gain between the two techniques.

    Conclusions:

    • Both ESFT and EDFT are comparable in terms of graft success and hearing outcomes for large TM perforations.
    • EDFT may involve longer operative times and an additional incision.
    • The study's small sample size limits definitive conclusions; larger trials are recommended to validate findings.