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Published on: January 19, 2022
Day-case Truly Scarless Endoscopic Tympanoplasty(TSET) with synthetic tissue graft in pediatric patients over 10
Petros D Karkos1, George Psillas1
1Department of Otolaryngology, AHEPA University Hospital, Thessaloniki, Greece.
Insights
Truly Scarless Endoscopic Tympanoplasty (TSET) using synthetic grafts is a successful and painless alternative for pediatric patients, offering excellent outcomes comparable to traditional microsurgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Innovation
Background:
- Evaluating the efficacy of Truly Scarless Endoscopic Tympanoplasty type 1 (TSET) in pediatric patients.
- Assessing the use of synthetic grafts in minimally invasive ear surgery.
Purpose of the Study:
- To determine the success rate of TSET with synthetic grafts in children.
- To compare TSET outcomes with traditional tympanoplasty techniques.
Main Methods:
- Prospective study involving 12 pediatric patients undergoing TSET.
- Strictly endoscopic underlay technique using a four-layered synthetic graft (Biodesign).
- No conversion to microscopic surgery or external incisions were required.
Main Results:
- Successful graft uptake in 11 out of 12 patients (91.7%).
- One case of microperforation occurred in a revision case.
- Operative times ranged from 40 to 130 minutes; all patients were discharged same-day.
Conclusions:
- TSET with synthetic grafts is a highly effective, painless, and scarless option for pediatric tympanoplasty.
- The procedure is suitable for day-case surgery with outcomes equivalent to traditional microsurgery.
- TSET offers advantages including no bandages, stitches, or external scars.
Background:
to evaluate the success of Truly Scarless Endoscopic Tympanoplasty type 1 (TSET) in pediatric patients with the use of synthetic graft.
Methods:
prospective study.
Results:
during a 6 year period 12 children underwent TSET using four layered tissue graft (Biodesign, Cook medical). This was a strictly endoscopic procedure with an underlay technique. No conversion to microscopic surgery was deemed necessary and no incision outside the ear canal was made, hence the term Truly Scarless Endoscopic Tympanoplasty (TSET) procedure. Operative time ranged from 40 min to 130 min. There were 11 boys and 1 girl aged 11-16 years. All patients were discharged on the same day with no bandage and just a cotton wool in the ear canal. All grafts survived except one who ended with a microperforation (8,3 %) that did not require futher surgery. The failed case was one of a total perforation with was a revision case from another institution and throughout the operation had persistent hypertension and a less than ideal operative field. Follow up of all 12 patients ranged from 12 to 60 months.
Conclusions:
TSET using synthetic material is an excellent alternative to classic pediatric tympanoplasty type I, it is painless, patients leave theatre with just a cotton wool in their ear canal, are discharged with no bandage, stitches or scars and is ideal for a day-case procedure. Success rates and graft failures are equivalent to classic ear microsurgery.
