Transcanal Myringoplasty Research Articles

Endoscopic transcanal underlay myringoplasty using a platelet-rich fibrin (PRF) membrane

BackgroundTympanic membrane perforations are among the most common indications for otological surgery. Surgeons from all around the world have made accidental and intentional contributions to find the perfect graft material and the best approach to perform tympanoplasty. Platelet-rich fibrin (PRF) use in myringoplasty has been popular in the last decade among many surgeons. We aimed to evaluate the efficacy of using PRF only as a graft material in myringoplasty.MethodsWe conducted a prospective study including 20 patients with dry central tympanic membrane perforations. The patients underwent endoscopic transcanal myringoplasty using a platelet-rich fibrin membrane by underlay technique. Follow-up was done 3 months postoperatively regarding graft uptake and hearing outcome by audiological assessment using pure tone audiometry.ResultsSixty percent of patients were surgically successful with complete healing of the tympanic membrane, 10% were partially successful with partial healing of the tympanic membrane, and 30% failed with complete loss of graft. The mean air-bone gap closure was 3.5 dB. No major complications were reported.ConclusionEndoscopic myringoplasty using platelet-rich fibrin alone can be performed in cases with tympanic membrane perforations as an alternative to using other autologous grafts. It is a new reliable method for myringoplasty, as well as being an easy, time-saving procedure that avoids the need for any skin incision.

Platelet Rich Fibrin Graft in Myringoplasty: Pitfalls and Challenges.

Autologous Platelet-rich fibrin (PRF) is an amalgam of fibrin mesh, platelets and growth factors that favour wound healing. It can be easily used as a graft material in myringoplasty, making it a promising, easy to harvest and cost effective alternative compared to cartilage or fascia graft used in conventional myringoplasty. 50 patients of small to medium, dry central perforation underwent myringoplasty using PRF graft (Group 1). Results were compared to 50 patients with similar small to medium perforations who underwent conventional transcanal myringoplasty using temporalis fascia graft (Group 2): Outcome of surgery was measured by closure of perforation and improvement in hearing at 3 months. In group 1, overall closure rate was 70% while in group 2 it was 96%. For both small and medium perforations healing was significantly higher in group 2 compared to group 1, (100% vs 87.5%) for small perforations and (95.45% vs 66.67%) for medium perforations. Hearing gain was comparable in both groups in patients in whom healing of perforation occurred. PRF stands as a suitable graft material for closure of small perforations, but, lack of rigidity and early disintegration of the graft makes it less suitable for larger perforations compared to other conventional grafts such as temporalis fascia.

Endoscopic permeatal “push-through” myringoplasty: hearing gain and graft uptake

BackgroundEndoscopic myringoplasty allows full visualization of the external ear canal, tympanic membrane, and middle ear without the need to reposition the patient’s head. The endoscope allows accessing hidden areas and structures not properly viewed by the microscope such as sinus tympani, facial recess, and hypotympanum. It also provides sharp, magnified image and shortens the duration of the surgery. The postoperative pain and morbidity are reduced and hence the hospital stay.The aim of this work was to evaluate the efficacy of the endoscopic-assisted permeatal transperforation “push-through” myringoplasty by assessing the graft take rate and hearing results.Our study included twenty patients (14 females and 6 males) with chronic suppurative otitis media without cholesteatoma that underwent endoscopic-assisted permeatal transperforation myringoplasty.ResultsThe case was considered '”successful'” if there was complete healing of the tympanic membrane and improvement of hearing. Graft uptake success rates were 85% with P-value 0.132. Average air-bone gap (A-B gap) preoperative was 18.20 dB; average A-B gap 1-month postoperative was 7.75 dB.ConclusionEndoscopic transcanal myringoplasty provided sharp, magnified visualization and operability as it avoids retroauricular skin incision and minimizes surgical procedures to expose hidden areas. There is less bleeding, a shorter operating time, less postoperative morbidity, and minimal postoperative care.

Endoscopic closure of tympanic membrane perforations by platelet-richplasma laden cartilage with perichondrium

Background: Myringoplasty surgery, also known as tympanic membrane repair, is performed to correct hearing loss brought on by TM perforation and to eliminate recurrent ear discharge. Platelets are the primary players in the process of tissue healing. They provide essential growth factors that stimulate fibroblasts to produce new blood vessels and lay down extracellular matrix. The study aim: Is to assess the efficacy of incorporating plateletrichplasma into tragal cartilage grafts with its perichondrium in order to speed healing and enhance the results of endoscopic transcanalmyringoplasty. Patients, and methods: Fifty people suffer from dry central TM perforation participated in this prospective case-control study. Under local anaesthesia, each of them had endoscopic transcanal myringoplasty by using tragal perichondrium grafts. 25 patients underwent myringoplasty surgery and also received platelet-richplasma (PRP) from the same patient in group A, compared to 25 patients in group B who underwent myringoplasty surgery but did not get PRP. Results: There were 25 patients in each group, and no statistically significant demographic differences existed between the two groups. A p-value of (0.01) indicates that there was a significant difference between the plattelet-rich plasma group's (100%) and the non-plattelet-rich plasma group's (72%) graft absorption success rates.

Endoscopic transcanal myringoplasty with anterior tab flap underlay technique: An analysis of 35 cases

IntroductionThe repair of the tympanic membrane can present a problem, especially in anterior perforation, because the anterior portion was not enough to inadequate contact between tympanic membrane remnant and graft. Various surgical techniques were recommended to achieve an acceptable graft success rate in anterior perforation. Endoscopic transcanal myringoplasty with anterior tab flap could provide the better stability of the graft. ObjectiveThe aim of this study was to report the minimally invasive technique for the anterior tympanic membrane perforation closure and investigate the graft success rate of this technique. Patients and methodsWe performed a prospective, randomized study of 35 patients who consulted the otorhinolaryngology department at the university hospital for surgery of perforation tympanic membrane repair. ResultsThe average age was 35.1 ± 11.9 years. The size of the perforation was dominant at small-size and large-size, 51.4%, 34.3%, respectively. There was a significant difference between the Preoperative air conduction of small and large perforations (34.44 8.68 and 49.79 14.54, respectively). Of 35 patients, 31 (88.6%) had closure of their perforations. The mean preoperative ABG was 24.11 ± 10.79 dB, while The mean postoperative ABG was 13.97 ± 10.03 dB (p < 0.05). Approximately 34.3% patients had ABG within 20 dB preoperatively, which increased to 82.9% after intervention (p < 0.05). ConclusionsThe endoscopic transcanal myringoplasty with anterior tab flap underlay technique is a safe, suitable and effective method for cases with anterior tympanic membrane perforations, and showed improvement in postoperative hearing.

ENDOSCOPIC TRANSCANAL TRANSTYMPANIC POP THROUGH TECHNIQUE OF MYRINGOPLASTY USING TRAGAL PERICHONDRIUM GRAFT

INTRODUCTION A perforated tympanic membrane is most commonly repaired using temporalis fascia graft by microscope assisted post auricular approach and underlay technique, we present an alternative technique to repair the perforated tympanic membrane using an alternative easily accessible graft material like tragal perichondrium, by endoscope assisted trans canalicular approach, where the graft is placed medial to the tympanic membrane remnant by pop through technique. OBJECTIVE T h e u s a g e o f r i g i d 4 m m e n d o s c o p e f o r myringoplasty allows better visualization, magnification and reconstruction of perforated tympanic membrane using tragal perichondrium is minimally invasive. The purpose of the study is to put across our experience in 69 patients where endoscopic assisted myringoplasty was done using tragal perichondrium graft. The graft was placed medial to the tympanic membrane remnant by trans tympanic pop through technique and tympanomeatal flap was not raised. METHOD This study was done over a period of 3 years, 69 patients with chronic suppurative otitis media fitting into the inclusion criteria underwent endoscopic transcanal myringoplasty using tragal perichondrium as graft material by underlay pop t h r o u g h t e c h n i q u e . T h e p o s t o p e r a t i v e audiological improvement in closure of air bone gap on pure tone audiometry, success in tragal perichondrium graft uptake, and mean operative time was evaluated. RESULTS The study population was 69 with predominantly females, the post operative pure tone audiometry showed that 39.1% had closure of airbone gap of 10db, 17.4% showed air bone gap closure of 20bd and 43.5 % showed air bone closure of 15db. 85% had success of graft uptake (i.e. complete closure of perforation) at 6 weeks post op .The mean operative time was 80 minutes. CONCLUSION Endoscopic assisted trans-canalicular (pop t h r o u g h t e c h n i q u e ) o f s i m p l e u n d e r l a y myringoplasty using tragal perichondrial graft is simple, minimally invasive with good post operative improvement in hearing and can be d o n e a s a d a y c a r e p r o c e d u r e w i t h o u t complications. KEYWORDS Endoscopic myringoplasty, tragal perichondrium , pop in technique.

Trans-canal tragal cartilage myringoplasty; a comparative analysis of endoscopic and microscopic approaches

BackgroundThe advent of Endoscopic Ear Surgery (EES) has allowed otologists an improved view of the surgical field compared with conventional Microscopic Ear Surgery (MES). EES presents different challenges for surgeons and a learning curve is necessary. AimsThe purpose of this study was to compare the efficacy of EES and MES for trans-canal tragal cartilage myringoplasty, an entry level EES. MethodsWe retrospectively analysed patients who underwent push through trans-canal tragal cartilage myringoplasty in our institution over 5 years (2016–2020). Exclusion criteria were: patients with prior ear surgery, non-tragal cartilage tympanic membrane graft, additional procedure at time of surgery and patients with insufficient follow up. EES and MES groups were compared using outcomes such as graft success rate, changes in pure tone audiometry (PTA), operative time and complications. ResultsSeventy-four patients met inclusion criteria (MES = 38, EES = 36). Mean age of included patients was 29.3 years with no significant demographic differences between groups. Graft success rate at 12 months was higher among the EES group versus MES (94.4% v 86.8%, p = 0.43). Mean operative time was reduced in the EES group (47.3 min v 53.8 min, p = 0.04). Hearing outcomes did not differ significantly between groups. No major operative complications occurred in either group. ConclusionsOutcomes were marginally better in the cohort who underwent EES. This supports that EES offers an otologic choice to complement established practice for trans-canal myringoplasty and may be used to facilitate introduction to EES for trainees and otologists wishing to learn this technique.

Transcanal Endoscopic Tympanoplasty: Our Experience at a Tertiary Care Centre.

Transcanal Myringoplasty can be performed with both microscope and endoscopes. Advancement in endoscopes has started the new era of minimal invasive surgery in otology practice. Endoscopic approach offers improved visualization with wider field of view, easy access to the hidden recesses of the middle ear, avoidance of a postauricular incision and less bony drilling. To report our experience with transcanal endoscopic tympanoplasty for tubotympanic type of COM and to evaluate its outcome in terms of morphological and functional success. Prospective study, conducted during September 2017 to August 2019, including 60 patients of tubotympanic type of COM. All patients underwent transcanal endoscopic type 1 tympanoplasty. Postoperative results i.e. graft uptake (morphological success) and hearing improvement (functional success) were evaluated at 6months. The graft take up rate was 93.33%. Preoperatively mean AB gap was 23.15 ± 7.23dB which was reduced to 11.68 ± 4.65dB at 6month postoperative follow up. The mean gain in AC threshold and AB gap was 15.43 ± 4.37dB and 11.46 ± 1.13dB respectively. Improvement in both AC threshold and AB gap was statistically significant (p < 0.0001). No major surgical or thermal injury related complications were observed. Although both microscopic and endoscopic techniques have their advantages and disadvantages, endoscopic technique can effectively replace traditional microscopic techniques in management of COM with satisfactory outcomes. We infer that EES offers less operative time, less postoperative pain, least complications and less hospital stay thus helping to reduce the physical and psychological burden placed on patients.

ENDOSCOPIC EAR SURGERY IN CROATIA - INITIAL RESULTS OF TOTAL ENDOSCOPIC TRANSCANAL MYRINGOPLASTY.

The aim of this study was to show clinical outcome in 56 patients with tympanic membrane perforation operated on by total endoscopic transcanal myringoplasty. Out of the total of 74 patients operated on exclusively endoscopically, we identified 56 patients in whom tympanoplasty type I (myringoplasty) was performed. In 43 patients (45 ears), myringoplasty was performed in a standard transcanal fashion with lifting of the tympanomeatal flap, and in 13 patient butterfly myringoplasty was performed. The size and position of perforation, surgery duration, hearing status and closure of the perforation were evaluated. Perforation closure was obtained in 50 of 58 ears (86.21%). The mean surgery duration was 62.69±22.56 minutes in both groups. Hearing improved significantly, with the preoperative mean air-bone gap of 20.41±9.29 dB improving to the postoperative mean air-bone gap of 9.05±7.77 dB. No major complications were recorded. Our results of graft success rate and hearing outcomes are comparable with those of microscopic myringoplasties but without the need for external incisions and with reduced surgical morbidity. Hence, we recommend total endoscopic transcanal myringoplasty as the method of choice for tympanic membrane perforation regardless of its size and location.

Effect of addition of platelet-rich fibrin to tragal perichondrium graft in the endoscopic trans-canal myringoplasty

BackgroundMyringoplasty operation is the reconstruction of the tympanic membrane (TM) which is performed to prevent recurrent discharge of the ear and to improve the hearing impairment which is caused by TM perforation. Platelets are the key factors in tissue repair mechanisms. They provide essential growth factors, which stimulate fibroblasts to create extracellular matrix deposition and neovascularization. The aim of this study is the assessment of the topical use of autologous platelet-rich fibrin (PRF) in the improvement of myringoplasty success rate.ResultsPatients were divided to two groups, group A included 20 patients who were submitted to myringoplasty operation with adding of PRF from the same patient, and group B included 20 patients who were submitted to myringoplasty operation without adding of PRF. At 6 months postoperatively, the success rate (graft taking) in case group A (95%) was significantly higher than in the control group (70%) (P value = 0.037). Success in terms of hearing gain of the air-bone gap was more than 10 dB achieved in 19 patients (95%) in case group A, and 14 patients (70%) in control group B were with a statistically non-significant difference (P value = 0.079). There was no effect of PRF use on hearing gain in graft-taken cases because hearing gain is related to the closure of TM.ConclusionTopical PRF application over tragal perichondreal graft during myringoplasty is successful, safe, and highly efficient with no complications. PRF improves healing of chronic TM perforations and prevents postoperative infection.

Novel Use of Platelet Rich Fibrin Membrane in Transcanal Myringoplasty: A Prospective Study-Letter to Editor.

This is a letter to the editor enlisting a few concerns and points of view which arose on reading a recently published article on the novel use of platelet rich fibrin membrane in transcanal myringoplasty.

Transcanal endoscopic myringoplasty: a retrospective study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Transcanal myringoplasty has the advantages of demanding lower operative time and minimal external incisions. It can be performed using the microscopic or endoscopic approach.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This retrospective study was conducted in the Department of ENT and Head and Neck Surgery, SMGS Hospital, Jammu from January 2018 to January 2020. Patients attending ENT OPD with central dry perforation of tympanic membrane were selected for endoscopic transcanal myringoplasty. Written and Informed consent were taken. During surgery, various parameters were noted including duration of surgery and hospitalization. These patients were followed through a period of 6 months and assessed using pure tone audiometry and graft uptake was seen. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of 40 patients, male: female ratio was 1.2:1. Time taken for surgery was less than 60 minutes in 16 (40%) patients whereas in 24 (60%) patients it was between 60-120 minutes. In our study the patients with small perforation had excellent graft uptake rates (18/19 patients, 94.73%), whereas patients with medium sized perforation showed graft uptake rate of 76.47% (13/17 patients). Objective analysis of cosmetic result was done at the end of six month and revealed that none of the patient had visible scar. Mean pre-operative air bone gap was 24.38 dB whereas mean postoperative air bone gap was 8.34 dB. Mean improvement comes out to be 16.04 dB.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Endoscopic myringoplasty was found to be equally effective, less morbid and very cost effective in small central perforations.&lt;/p&gt;

Endoscopic Transcanal Myringoplasty-Smart Myringoplasty for Nex Gen ENT Surgeons: Our Experience.

Otolaryngology is one of the branch where endoscopes is being widely used nowadays to perform different surgeries. Ear surgeries are of special interest among the ENT surgeons. It has several advantages compared to the microscopes. 60 patients underwent endoscopic transcanal myringoplasty by the postgraduate residents under direct supervision of same consultants, using temporalis facia graft. The overall success rate in terms of graft uptake was 86.67% and the AB gap closure of < 10 dB in 63.3% of cases and 10-20 dB in 33.3%. Endoscopic myringoplasty was found to be equally effective, less morbid and very cost effective than the microscopic myringoplasty. This was applicable irrespective of the size of the perforation and condition of the middle ear (dry/wet) in our centre.

Novel Use of Platelet Rich Fibrin Membrane in Transcanal Myringoplasty: A Prospective Study

Being rich in growth factors platelet rich fibrin (PRF) has been used for decades for its healing properties in cosmetic surgeries but its use in transcanal myringoplasty is a novel approach that remains unexplored. In todays era of minimally invasive surgery not only does it provide as a great alternative to conventional myringoplasty but also outshines it. It reduces post operative pain, hospital stay and unlike the conventional technique that uses termporalis fascia as a graft material, PRF myringoplasty if required can be reperformed on the same patient multiple times with minimal risk. This procedure comes as a boon for patients with recurrent graft defects because after multiple revision surgeries, temporalis fascia can be deficient and other graft materials like cartilage/perichondrium or fascia lata etc. have to be harvested surgically for myringoplasty. In PRF myringoplasty there is no upper limit in the number of times the PRF membrane can be made and also it does not entail any surgical incision for graft harvest. A prospective study involving 41 patients was conducted at Netaji Subhash Chandra Bose Medical College, Jabalpur where in the tympanic membrane perforations were repaired using PRF membrane with a successful outcome in 85.4% of the patients included in this study.

Comparative Study between Endoscopic Transcanal Myringoplasty Versus Microscopic Myringoplasty in middle age group (20-40 years)

Background: The surgical goals of myringoplasty are the closure of the tympanic membrane perforation and improvement of the hearing levels. Aim of the work: To compare the results, advantages and disadvantages between endoscope and microscope in myringoplasty. PATIENTS AND METHODS: This study was carried out in the Otorhinolaryngology Department at Alhussin and Bab-Alsharia University Hospitals. The study included 40 patients with a diagnosis of chronic suppurative otitis media of tubo-tympanic type, divided into two groups and each group contained 20 patients. All patients were operated by one surgeon. Results: The difference in age, sex, side of diseased ear and size of perforation between the two groups was not significant. In group (A) the circumference of the perforation was clearly visualized in all patients (100%). While, in group (B) the circumference of the perforation could not be visualized in 7 patients (35%), 5 patients (25%) required external auditory canal curettage and 2 patients (10%) required endoscope-assisted microscopic myringoplasty to evaluate the ossicular chain. The difference between the 2 groups was significant (P.value = 0.004). In group (A) the graft was uptaken in 85% of patients while in group (B) the graft was uptaken in 80% of patients with no significant difference between the two groups (p = 0.677). Conclusion: The ability to easily negotiate through EAC, Panoramic, wide angle, and magnified view provided by the endoscope and uninterrupted picture overcomes most of the disadvantage of the microscope.

Comparative Study between Endoscopic Transcanal Myringoplasty Versus Microscopic Myringoplasty in middle age group (20-40 years)

Background: The surgical goals of myringoplasty are the closure of the tympanic membrane perforation and improvement of the hearing levels. Aim of the work: To compare the results, advantages and disadvantages between endoscope and microscope in myringoplasty. PATIENTS AND METHODS: This study was carried out in the Otorhinolaryngology Department at Alhussin and Bab-Alsharia University Hospitals. The study included 40 patients with a diagnosis of chronic suppurative otitis media of tubo-tympanic type, divided into two groups and each group contained 20 patients. All patients were operated by one surgeon. Results: The difference in age, sex, side of diseased ear and size of perforation between the two groups was not significant. In group (A) the circumference of the perforation was clearly visualized in all patients (100%). While, in group (B) the circumference of the perforation could not be visualized in 7 patients (35%), 5 patients (25%) required external auditory canal curettage and 2 patients (10%) required endoscope-assisted microscopic myringoplasty to evaluate the ossicular chain. The difference between the 2 groups was significant (P.value = 0.004). In group (A) the graft was uptaken in 85% of patients while in group (B) the graft was uptaken in 80% of patients with no significant difference between the two groups (p = 0.677). Conclusion: The ability to easily negotiate through EAC, Panoramic, wide angle, and magnified view provided by the endoscope and uninterrupted picture overcomes most of the disadvantage of the microscope.

Half-thickness tragal cartilage slicing improves the sound transmission properties in endoscopic myringoplasty among Egyptians

Purpose: To compare full and half thickness tragal cartilage in endoscopic myringoplasty by using cartilage slicer. Patients and Methods: This study was conducted at the ENT Department at Minia University Hospital and included 32 patients with chronic suppurative otitis media attending the E.N.T. outpatient clinic. The Patients were divided into two groups, 16 patients were included in group A, where a half thickness tragal cartilage graft was used and 16 patients included in group B where a full thickness tragal cartilage graft was used for myringoplasty. Underlay graft technique was used in all cases by endoscopic assisted transcanal myringoplasty. Result: The graft was taken in 30 patients, 15 in each, so the graft takes up rate is 93.8% in both groups. Difference in hearing gain was not statistically significant between the two groups, except at 4,000 Hz; where hearing gain in half thickness tragal cartilage (Group A) is more than full thickness tragal cartilage (Group B). For both groups, hearing gain was more at 250, 500 Hz than at1000, 2000, 4000 and 8000 Hz frequencies. Conclusion: Our data show that slicing of the tragal cartilage into half (0.5mm) is suitable to improve the sound transmission properties of the reconstructed tympanic membrane in comparison to the full thickness tragal cartilage (1.0 mm).

Endoscopic myringoplasty: outcome and hearing gain in inactive mucosal chronic otitis media

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media is an inflammatory process in the middle ear cleft that poses serious health problem in developing countries. Myringoplasty is a common otological procedure to reconstruct the tympanic membrane to prevent recurrent otorrhea, and restore sound-conducting mechanism. The use of rigid endoscope in transcanal myringoplasty has significant advantage as it provides magnified, close up as well as wide angle view, less morbidity and early postoperative wound healing with better cosmetic results without compromising success rate and postoperative hearing gain. The aims and objectives of the study were to analyze the results of endoscopic transcanal interlay myringoplasty, in terms of graft uptake and hearing improvement in cases of chronic suppurative otitis media with inactive mucosal disease with central perforation.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a prospective study conducted from January 2016 to August 2018 in 30 patients of inactive mucosal chronic otitis media (COM). All patients underwent transcanal endoscopic interlay myringoplasty and patients were called for regular follow up for 12 weeks and results were statistically analysed. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The graft uptake rate in the present study was found to be 93.33%. Pre operatively mean air bone gap (ABG) was 27.33 dB and post operatively after 12 weeks mean air bone gap improved to 10.5 dB. Mean ABG gain was 16.33%.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Endoscopic transcanal interlay myringoplasty with superiorly based TM flap is an effective technique over conventional microscopic technique in terms of graft uptake, hearing improvement, better postoperative scar and less morbidity in cases of inactive mucosal COM.&lt;/p&gt;

Endoscopic transcanal myringoplasty:Is learning curve a myth?

ObjectiveTo investigate the feasibility of transcanal endoscopic myringoplasty in the hand of young beginner surgeons who had just completed the residency programme. MethodsIn a three year period (August 2012 to August 2015), 44 ears in 42 patients were operated upon by a beginner surgeon through the transcanal endoscopic approach in a subdistrict level hospital located in the north western ranges of the Himalayan region. ResultsOf the 42 patient, 19 were male and 23 female. The mean age was 26.23 years (range: 15–47 years). In 40 ears, complete perforation closure was achieved at six months (success rate: 90.9%). The mean air conduction PTA preoperatively was 40.84 dB HL and improved to 28.06 dB HL postoperatively (p < .001). The mean AB gap preoperatively was 22.40 dB, which improved to 9.1 dB postoperatively (p < .001). ConclusionEndoscopic transcanal myringoplasty is safe and reliable even in young beginners' hands. Surgeons can consider endoscopic approach early in their careers without the fear of learning curve. The cost of endoscopic equipment is about one tenth as compared to open approach under a operating microscope, and an added advantage.

Short-term Subjective and Objective Outcomes of Patients Receiving Endoscopic Transcanal Myringoplasty for Repairing Tympanic Perforations.

Objective Endoscopic transcanal myringoplasty (ETM) has been an emerging technique for repairing tympanic perforations since the late 1990s. Objective outcomes (ie, graft success rates and hearing results) of patients who received ETM are well documented; however, subjective outcomes of these patients have rarely been reported. Hence, this study evaluated subjective and objective outcomes of patients who received ETM for repairing tympanic perforations. Study Design Prospective study. Setting Tertiary care university hospital. Patients and Methods Patients who underwent ETM for perforations of the tympanic membrane were included. We evaluated subjective variables of patients receiving ETM as the primary outcome and objective variables as the secondary outcome. Results In total, 91 ears that underwent ETM were included. The mean pain scale score was 0.1 (range, 0-2) on postoperative day 3. The mean duration of pain medication was 2.0 (range, 0-3) days. The mean number of days required to resume routine activities was 1.0 (range, 1-2) days. The overall graft success was determined postoperatively at 3 months in 80 of 91 ears (87.9%). Closure of the air-bone gap to within 20 dB was achieved in 79 (86.8%) ears. Conclusion In this study, patients who received ETM had mild postoperative pain and resumed routine activities early. These patients also exhibited favorable graft success rates and hearing results at 3 months postoperatively. On the basis of our results, we conclude that patients who receive ETM for the repair of tympanic perforations have favorable short-term subjective and objective outcomes.