Clip Myringoplasty

Perforations of the tympanic membrane result mainly from otitis media or trauma, and we need grafting when a perforation is chronically persistent to prevent recurring infections and to enhance hearing. In the present study, we assessed the success rate, feasibility, and efficacy of endoscopic transcanal tympanoplasty using tragal cartilage grafts via the clip technique.

This prospective study was performed between September 2017 and December 2021 and was conducted in ENT departments in tertiary hospitals. Forty patients underwent endoscopic clip technique tragal cartilage type 1 tympanoplasty. Patients with dry (for 3 months at least) small (less than 3 mm), medium (3-5 mm), or large (more than 5 mm) central perforations but not marginal perforations.

TM perforation healing following the procedure for 6 months was achieved in 100% of the patients with small perforations, 18 of 19 (94.73%) with medium perforations and 11 of 12 (91.6%) with large perforations. At 6 months post-surgery, hearing improvement, as confirmed by audiometric results, was approximately 12.41 ± 1.01 dB. There was a highly significant improvement in the A-B gap (air-bone gap).

Endoscopic chondro-perichondrial tragal graft with the clip technique for the repair of small-, medium-, and large-sized nonmarginal TM perforations is a minimally invasive, safe and effective technique compared with the conventional myringoplasty technique. It provided good results (closure of both the perforation and the air-bone gap), minimized morbidity, reduced the operative time, increased patient compliance, and reduced the duration of hospital admission.