First Endoscopic Transplantation of a Tympanic Allograft: A Preliminary Report

Allograft tympanoplasty is a proven effective technique to restore eardrum and/or the ossicular chain. Before this manuscript, this technique always required a retroauricular incision. Ironically, the prelevation of the donor graft has been performed endoscopically for some years now. Here the authors present the first case of a successful endoscopic allograft tympanoplasty.

Reconstruction of a subtotal eardrum perforation with endaural endoscopic placement of a tympanic allograft.

A 28 years old man of African origin presented with a central kidney-shaped subtotal perforation and moderate-severe conductive hearing loss (pure tone average: 62 decibels; air-bone gap: 42 decibels). For such large perforations Allograft Tympano-Ossicular System (ATOS) tympanoplasty can be applied. Because of the patient's African origin and dark skin type, an endoscopic endaural approach was chosen over a retroauricular approach to work less invasive and avoid keloid formation.

During surgery, an endoscopic endaural placement of an ATOS was executed in the same manner as in cases with conventional retroauricular incisions. Follow-up care was identical to conventional cases. At his last visit, the perforated eardrum was closed with also an improved hearing (mild hearing loss; pure tone average: 23 decibels; air-bone gap: 8 decibels). After at least 3 months no severe adverse events were seen, and he was discharged from follow-up.

Endoscopic placement of an ATOS is an effective and minimally invasive technique to restore challenging eardrum perforations.