Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations.

Abstract

We evaluated the graft take rate and hearing gain of endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap for repairing an anterior tympanic membrane perforation. A retrospective case series. Tertiary university hospital. The study population consisted of patients with an anterior perforation undergoing endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap. The primary outcome was the graft take rate at 6 months. The secondary outcomes were the air-bone gap (ABG) gain at 3 months and complications. A total of 51 patients with a unilateral anterior marginal perforation were included in this study. The mean operation time was 62.2 ± 8.3 minutes. The graft success rate was 92.2% (47/51) at 6 months. The mean preoperative ABG was 28.07 ± 5.13 dB, while the mean postoperative ABG was 12.24 ± 4.89 dB (P < .05). No patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus. Two patients with a middle perforation developed postoperative purulent otorrhea that resulted in residual perforations. The cartilage graft was extruded into the anterior annulus in two patients with large perforations that resulted in graft lateralization in one patient and residual perforation in the other. Endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap is a useful procedure with a low reperforation rate for repairing anterior perforation.