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Updated: Jun 24, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Endoscopic Myringoplasty for Pediatric Tympanic Membrane Perforations: Is It Worth It?
Riccardo Nocini1, Daniele Monzani1, Valerio Arietti1
1Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy.
Insights
Endoscopic tympanoplasty is a safe and effective procedure for repairing pediatric eardrum perforations. This study shows a high closure rate and significant hearing improvement in children undergoing this minimally invasive surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Technology
Background:
- Endoscopic tympanoplasty is an established technique for tympanic membrane perforation repair.
- Limited research exists on its success rates specifically in pediatric populations.
- This study addresses the need for data on endoscopic tympanoplasty in children.
Purpose of the Study:
- To evaluate the success rate of type 1 transcanal endoscopic tympanoplasty in pediatric patients.
- To assess both anatomic (graft closure) and functional (air-bone gap reduction) outcomes.
- To determine the safety and efficacy of the procedure in this age group.
Main Methods:
- Retrospective analysis of 84 type 1 transcanal endoscopic tympanoplasties in pediatric patients (ages 4-16).
- Inclusion criteria: simple chronic otitis media, trauma, or idiopathic perforations; exclusion: cholesteatoma, other pathologies, <12 months follow-up.
- Graft material: temporal fascia or tragal cartilage; outcomes measured by graft integrity and air-bone gap (ABG) reduction.
Main Results:
- High primary surgical closure rate of 92.9% (78/84 ears).
- Significant mean ABG reduction from 17.13 dB HL preoperatively to 9.16 dB HL postoperatively (7.97 dB HL improvement).
- No significant intraoperative or postoperative complications were reported.
Conclusions:
- Transcanal endoscopic type 1 tympanoplasty demonstrates a high success rate in pediatric patients.
- The procedure is safe and leads to significant functional hearing improvement.
- Endoscopic tympanoplasty is a viable and effective option for pediatric eardrum perforation repair.
Abstract:
Background/Objectives: The endoscopic repair of the tympanic membrane is an established method for addressing perforations in the tympanic membrane. However, there are limited studies in the literature examining the success rate of this procedure in the pediatric population. Methods: This study retrospectively analyzed data from the tertiary referral center at the University Hospital of Verona, Italy. This medical record contains data from 84 type 1 transcanal endoscopic tympanoplasties performed in pediatric patients between November 2014 and February 2022. Seventy-seven pediatric patients aged 4 to 16 years who underwent type 1 transcanal endoscopic tympanoplasty (seven of whom underwent bilateral surgery at different time points) were included in the study. Our study did not include more extensive procedures than type 1 endoscopic tympanoplasty. Only patients with tympanic membrane perforation due to simple chronic otitis media, trauma or when no apparent cause was found were included. Chronic otitis with cholesteatoma and other pathologies of the external or middle ear were exclusion criteria. Patients with a follow-up of less than 12 months were excluded from this study. The technique was based on the endoscopic placement of an underlay graft of temporal fascia or tragal cartilage to repair a tympanic membrane perforation. Demographic, clinical, audiologic, and surgical data were collected from each patient. In the study, we considered the reduction of the air-bone gap (ABG) as a functional outcome and the integrity of the reconstruction as an anatomic outcome of success. Results: The primary surgery had a closure rate of 92.9% (78 of 84). All patients underwent audiological evaluation 4-6 months post-surgery, with 84 ears tested. The mean preoperative ABG was 17.13 dB HL, reduced to 9.16 dB HL postoperatively, showing a mean reduction of 7.97 dB HL. No significant complications occurred. Conclusions: Transcanal endoscopic type 1 tympanoplasty should be considered a safe procedure with a high success rate for the repair of tympanic membrane perforations, even in pediatric patients.
