Tympanoplasty Surgery Research Articles

The Impact of Cubism Graft on The Outcome of Tympanoplasty Surgery

The Impact of Cubism Graft on The Outcome of Tympanoplasty Surgery

COMPARISON EFECTIVENESS OF DEXMEDETOMIDINE VERSUS DEXMEDETOMIDINE WITH KETAMINE FOR TYMPANOPLASTY SURGERY DONE UNDER MONITOREDANAESTHESIA CARE

Background: Monitored Anaesthesia Care (MAC) has been widely used for patients undergoing middle ear surgeries. The use of dexmedetomidine in middle ear surgeries as a sole anaesthetic agent had many disadvantages owing to its insufficient sedative effect, increased recovery time and haemodynamic instability. Aims and objectives: To evaluate the effectiveness of dexmedetomidine and ketamine combination in comparison with dexmedetomidine alone for tympanoplasty surgery under MAC. Materials and Methods: In this cross sectional observational study, a total of 100 patients were included. Before the surgery, group D received 1 μg/kg dexmedetomidine followed by infusion of 0.2μg/kg/h to maintain 2 or 3 of modified observers assessment of analgesia and sedation score. The patients in group DK received 1 μg/kg dexmedetomidine followed by infusion of 0.2μg/kg/h plus ketamine 0.5mg/kg 10 minutes before the start of the procedure. Results: In the present study total of 100 patients were included, among which 66.0% were females and 34.0% were males. The mean age of 100 patients was 38.3±11.34 years. There were no differences in baseline measurements of HR, SBP and DBP between the two groups, but Group DK had significant fall in heart rate (5-10%) (P < 0.001). Average patients and surgeons satisfaction with sedation and analgesia was higher in Group DK than Group D (P = 0.001). Conclusion: Dexmedetomidine and ketamine combination provides good haemodynamic stability, higher sedation score with safe and effective method of anaesthesia that provides good MAC for patients undergoing tympanoplasty surgery.

Assessment of Eustachian Tube Function for Successful Tympanoplasty in Chronic Otitis Media

Introduction: Eustachian tube function (ETF) has been the focus of attention as a prognostic factor for successful tympanoplasty surgery, due to its supposed primary pathogenic role in otitis media. Poor Eustachian tube (ET) function has been blamed to many diseases of middle ear cleft extending from serous otitis media to the squamosal type of chronic otitis media (COM). The objective of this study was to evaluate the effect of ETF on tympanoplasty outcome in the mucosal type of COM patients. Materials and Methods: An observational study was conducted for the patients admitted to the department of ENT and HNS with COM, mucosal type. The study was done from April 2021 to March 2022. ETF was assessed with the Toynbee test and saccharin time test. Results: The mean saccharin clearance time was found to be 17 min. Tympanoplasty was performed on 55 patients; 91.1% of patients showed successful outcome with good graft uptake who had normal ETF; out of 20 patients with partial dysfunction, 12 patients had successful graft uptake, and eight patients showed graft rejection. Conclusion: The automatic Toynbee test can be a practical, objective, and suitable method to assess the ventilatory function of ET. The saccharin test is an easy, cost-effective, and useful diagnostic tool to assess the mucociliary function of the ET. The ventilatory function of ET which is the single most important contributory factor in the pathogenesis of COM should be evaluated with the objective method before tympanoplasty.

Monitored Anesthesia Care in Tympanoplasty a Comparative Study of Pentazocine Phenargan Combination versus Pentazocine Dexmedetomidine

The objective of this study was to compare the effectiveness and safety of two different drug combinations used for monitored anesthesia care (MAC) in tympanoplasty procedures. The first combination consisted of pentazocine and phenergan, while the second combination included pentazocine and dexmedetomidine. A prospective, randomized controlled trial was conducted on patients scheduled for tympanoplasty surgery. A total of 100 patients were randomly assigned to either the pentazocine-phenergan group or the pentazocine-dexmedetomidine group. The primary outcome measured included the level of sedation achieved, pain scores during surgery, and the incidence of adverse events such as respiratory depression, nausea, vomiting, bradycardia and hypotention. The results showed that the pentazocine-dexmedetomidine combination achieved a higher sedation score and lower pain scores compared to the pentazocine-phenergan combination. Sedation score in Group PP mean RSS of 1.928571429, while Group PD had a higher mean RSS score of 3.142857143 also VAS scores in Group PP mean VAS sore of 4.542857143, and Group PD had mean VAS score of 3.285714286. However, higher incidences of adverse events were noted in Group PD compared with Group PP. In conclusion, this comparative study suggests that the pentazocine-dexmedetomidine combination may offer superior sedative effects and better analgesia compared to the pentazocine-phenergan combination during tympanoplasty with manageable adverse effects.

Temporal bone CT-based anatomical parameters associated with the development of cholesteatoma

BackgroundCholesteatoma is caused by disorders of the middle ear ventilation that trigger a progressive series of events responsible for its formation. The aim of this study was to identify possible radiological CT-derived parameters predisposing to ventilation disorders and cholesteatoma.MethodsIn this retrospective study, patients diagnosed with cholesteatomatous chronic otitis media who underwent temporal bone CT and open tympanoplasty surgery have been included, as well as control patients with clinical examination negative for organic otological pathology who underwent temporal bone CT for other reasons. For each patient, the following parameters have been extracted from CT volumes: degree of mastoid pneumatization, prominence of the cog, patency of the Eustachian tube, antrum width, aditus width, anterior and posterior epitympanic widths, and epitympanic height.ResultsSixty patients have been included, thirty of whom belonged to the group of patients with cholesteatoma and the remaining part to the group of patients without organic otological pathology. The prevalence of a low degree of mastoid pneumatization was significantly higher among patients with cholesteatoma, as well as for the prevalence of cog prominence (p < 0.001). All the continuous variables were found to have statistical significance (p < 0.05) in the comparison between groups except for the width of the antrum.ConclusionMastoid pneumatization degree, prominence of the cog and epitympanic measures based on temporal bone CT could be good radiological correlates of the ventilatory capabilities of the epitympanum which, if compromised, can facilitate the development of cholesteatoma.

RESULTS OF MORPHOLOGICAL AND FUNCTIONAL EXAMINATION OF TYMPANOPLASTY IN THE NEAR AND LONG TERMS

In the period after tympanoplasty surgery, certain clinical morphological processes take place in the tympanic cavity, tympanic membrane, and external auditory canal, and the mucus layer of the tympanic cavity is restored, the permeability and barofunction of the auditory canal are restored. This process continues for a long time, and the transplants restore their optimal functional state. In our observation, morphological changes in the tympanic membrane, tympanic cavity, and external auditory canal lasted from 1 to 6 months. Therefore, it is important to observe morphological changes in the tympanic membrane and study functional changes.

Evaluation of hearing limits post tympanoplasty in patients with chronic suppurative otitis media

Link of Video Abstract: https://youtu.be/Nr9MKgu2v2E Background: Chronic suppurative otitis media (CSOM) causes partial or complete damage to the tympanic membrane and ossicles, causing hearing loss in the form of conductive and mixed hearing loss with a decrease of up to 60 dB. This study aimed to evaluate the hearing threshold before and after tympanoplasty surgery in CSOM patients. Methods: This type of research was carried out in a retrospective descriptive manner. The materials in this study were the medical records of CSOM patients who underwent canal wall up (CWU) tympanoplasty and canal wall down (CWD) tympanoplasty at the outpatients of ear, nose, and throat – head and neck surgery (ENT-HNS) Otology Division Dr. Soetomo Hospital Surabaya for the period January 1, 2018 to December 31, 2018 with a total of 51 patients. This study analyzed with the Wilcoxon test. Results: The mean age was 30.96 years (51% female and 49% male). Postoperatively 40 (78.5%) patients experienced an increase in hearing threshold, 10 (19.6%) patients experienced a decrease and 1 (1.9%) patient remained. The average increase in air-bone gap (ABG) pre and post tympanoplasty surgery was 9.78 dB, from 38.92 dB to 29.14 dB. Conclusion: There was an increase in hearing threshold after tympanoplasty.

Saccharin Test Time as a New Prognostic Predictor of Tympanoplasty.

In India, Chronic suppurative otitis media (CSOM) is a general public health issue leading to hearing loss which can be corrected surgically by Tympanoplasty. By applying predictors for a successful surgery the effectiveness of the surgery can be improved. In this study we aim to determine the usefulness of prognostic factors in predicting outcome of surgery for better patient compliance. 1. To compare MERI scores and saccharin test time in predicting graft uptake and hearing outcomes in Tympanoplasty surgery. A prospective study included all cases of mucosal type of CSOM of either sex according to the inclusion and exclusion criteria. Saccharin clearance time was used to assess Eustachian tube function and Pure Tone Audiometry has been done Pre-operatively to assess Hearing. Risk categories were assigned using MERI scoring chart and severity of disease assessed by otomicroscopy during surgery. Patients were post-operatively followed up to 6months. Outcomes were assessed using Graft uptake, Hearing improvement and for recurrence of infection, compared with different categories of MERI and Saccharin time. The overall graft uptake was 96.6%. 100% successful graft uptake was seen among normal eustachian tube function. Hearing improvement after surgery may be predicted by saccharin and MERI test. Abnormal Saccharin test shows guarded prognosis in predicting the success of middle ear surgeries. Based on the MERI score and saccharin clearance time, hearing benefit and Surgical success can be assessed and patients can be counselled prior surgery regarding the expected outcome.

Investigation of factors affecting pediatric type 1 endoscopic tympanoplasty results and success rates of surgery

ObjectiveThere are many factors that affect the results of tympanoplasty in children. Recurrent ear infections, hearing loss, and more serious complications due to cholesteatoma may be observed. This study examined factors affecting the success of type 1 endoscopic tympanoplasty surgery in pediatric patients and investigated recommended procedures to increase the success of the operation. MethodsOur study included pediatric patients who underwent type 1 endoscopic tympanoplasty operation for chronic otitis media. Patient files were analyzed retrospectively. Hearing results before and after the operations were recorded.. Patients were divided into groups according to gender, age (<12 age group, ≥12 age group), and perforation type. Hearing results and physical examination findings were compared for each group. ResultsA total of 204 pediatric patients were included in our study: 114 were male and 90 were female. Patients’ hearing results were compared according to the size and location of their tympanic membrane perforations. Hearing loss was found to increase as the size of the tympanic membrane perforation increased. In addition, it was observed that perforations in the posterior quadrant caused more severe hearing loss than in the other quadrants. The postoperative results of the two groups <12 years old, and ≥12 years old were evaluated according to age. Postoperative improvement was higher in the ≥12 age group compared to the <12 age group. ConclusionAccording to the results of this study, tympanoplasty surgeries performed on patients younger than 12 have a decreased success rate. Among the many factors that affect the success of an operation, age is one of the most important. There are many factors that affect the results of the operation, perforation size and localization is one of them. There are many factors that affect the success of surgery such as pediatric patients and adult patients. It is useful to make a personal evaluation and to plan the surgery by evaluating the obstacles such as eustachian tube maturation and difficulty in postoperative care in pediatric patients.

Does young otologists’ method of initiation to tympanoplasty make a difference?

Objectives: The study aimed to identify which surgical method will provide an easier initiation to tympanoplasty for young otolaryngology residents and which method will achieve more successful results. Patients and Methods: The files of 58 patients who underwent type 1 tympanoplasty were retrospectively reviewed between September 2020 and September 2021. Patients were divided into two groups according to the surgical procedure as the microscopic (MT) and the endoscopic (ET) group. The ET group included 30 patients (16 females, 14 males; median age: 36.5 years range, 18 to 56 years), and the MT group included 28 patients (15 males, 13 females; median age: 29.5 years; range, 18 to 52 years). The two groups were compared in terms of pre- and postoperative audiometry results and graft success rates. Results: There was no significant difference between the two groups in terms of pre- and postoperative air-bone conduction pure tone averages and air-bone gap (p&gt;0.05). Air-bone gap gain was 13 dB in the ET group and 9.42 dB in the MT group, and this difference was statistically significant (p&lt;0.05). The graft success rate was 86.7% in the ET group and 75% in the MT group, but there was no significant difference between the two groups (p&gt;0.05). Conclusion: Although the air-bone gap gain was better in the ET group in our study, it can be said that this difference was clinically negligible. We believe that conducting such a study with more surgeons and surgical cases may guide the otolaryngology residents to start type 1 tympanoplasty surgery.

Type 1 Tympanoplasty by Interlay Technique for Management of Tympanic Membrane Perforation

Tympanic membrane is the partition between the external ear and middle layer which is a vital component of the human ear. Neglected or maltreated earache, ear discharge and trauma lead to perforation of tympanic membrane. Tympanoplasty is the surgical procedure performed to repair a perforated tympanic membrane, with/without reconstruction of the ossicles, with the aim of preventing reinfection and restoring hearing ability. Type 1 tympanoplasty is the simple closure of the tympanic membrane perforation. To study the outcome of type 1 tympanoplasty operation by interlay technique, a descriptive longitudinal study was conducted among 200 patients in Community Based Medical College Hospital and in private clinics of Mymensingh from January 2012 to December 2021. Our inclusion criteria was population of age ranging from 15 to 55 yrs of both sexes having dry central perforation for at least 6 weeks and exclusion criteria was patient with active stage of chronic suppurative otitis media (CSOM), ossicular discontinuity, sensory neural hearing loss. Data was analyzed by SPSS version 20.0. Prevalence of taking graft was 96.00%. Measured by difference of preoperative air bone gap (ABG) and postoperative ABG of 15 decibel (dB) hearing improvement rate was 90%. Complication was minimal (1%). The complication was infection due to non-compliance with postoperative advice and treatment. Type 1 tympanoplasty done by interlay technique has excellent results both in terms of graft taken and hearing improvement with minimal complications.&#x0D; CBMJ 2023 January: Vol. 12 No. 01 P: 67-72

Long-Term Results of Tragal Cartilage Type 1 Tympanoplasty

Aim: Tympanoplasty is one of the most frequently performed operations by ear, nose, and throat specialists. Surgical treatment of tympanoplasty aims to obtain a healthy ear membrane and minimise hearing loss. The purpose of this study was to evaluate the success of the graft and functional hearing outcomes of patients applied with tragal cartilage type 1 tympanoplasty operation in our clinic. Materials and Methods: This study included 43 patients who underwent tragal cartilage type 1 tympanoplasty operation between January 2016 and November 2020. A retrospective evaluation was made of the preoperative pure tone audiometry (PTA) values and the operative findings. In the follow-up examination, the graft status and PTA results were recorded. The graft success and improvements in hearing were evaluated in all the patients. Results: A total of 43 patients were evaluated, comprising 24 males and 19 females with a mean age of 31.2 years (range, 13-58 years). The operation was performed on the right ear of 22 patients and the left ear of 21. The tympanoplasty operation was performed with an endaural approach in 6 cases and a postauricular approach in 37. The mean follow-up period was 20.8 months (range, 12-39 months). The rate of graft success of all the patients was 88.4%. The mean air conduction threshold, air-bone gap, and bone conduction threshold values at 500, 1000, 2000, and 4000 Hz were determined to have statistically significantly decreased postoperatively in comparison with the preoperative values (p&amp;lt;0.05). Conclusion: In tragal cartilage type 1 tympanoplasty operations, high rates of graft success were obtained and a dramatic gain in hearing postoperatively.

Comparison of Tympanoplasty Done with Removal of Posterior Canal Wall Skin versus Tympanoplasty Done with Preservation of Canal Wall Skin

Aims and Objectives: The aim of this study is to compare the outcomes of type 1 tympanoplasty in terms of graft uptake, hearing improvement, operative time, and healing time in patients operated with posterior canal skin preservation or without it. Materials and Methods: This is a prospective study of 100 patients operated for type 1 tympanoplasty surgery at a tertiary care hospital from August 2021 to June 2023 and operated by a single surgeon. Patients were divided into two groups and were randomly allocated (one with posterior canal skin preservation and other without it). Inclusion criteria were all patients operated for tympanoplasty between 12 and 50 years of age. Exclusion criteria were patients with mixed hearing loss or sensorineural hearing loss and patients who had to undergo ossicular chain reconstruction and revision cases were also excluded from the study. The outcomes were evaluated on follow-up by otoendoscopy and pure-tone audiometry. Observation and Discussion: In terms of graft uptake at 3-month postoperative period, no significant difference was found between both the groups. In terms of hearing improvement and healing time, P &gt; 0.1 was noted, and hence the difference was not significant. However, the operative time was significantly lower for the group with posterior canal wall skin removal. Conclusion: Removal of skin from posterior surface of external auditory canal improves visualization during tympanoplasty. It reduces operative time and provides same success rates in terms of graft uptake and hearing improvement. It has almost the same healing time, and granulations or other canal-related complications are minimal. Graft medialization or lateralization is also minimal when anterior tucking and lateral tucking of graft is done.

Comparison of dexmedetomidine-fentanyl and dexmedetomidine-pentazocine for monitored anesthesia care during tympanoplasty surgery

Comparison of dexmedetomidine-fentanyl and dexmedetomidine-pentazocine for monitored anesthesia care during tympanoplasty surgery

Comparative study between anterior tucking and tunneling of graft in Type-1 tympanoplasty

Background: Tympanoplasty is the surgical procedure performed to repair a perforated tympanic membrane, with or without reconstruction of the ossicles, with the aim of preventing reinfection and restoring hearing ability. There are various techniques to perform Type 1 tympanoplasty. Aims and Objectives: · To compare anterior tucking and tunneling of temporalis fascia graft in Type 1 tympanoplasty based on the clinical and audiological outcome. · To study the hearing outcome and graft uptake in anterior tucking technique and anterior tunneling technique in Type 1 tympanoplasty. · To compare the hearing outcome and graft uptake in anterior tucking versus anterior tunneling technique in Type 1 tympanoplasty. Materials and Methods: The study was carried out in the Department of Otorhinolaryngology (ENT), Maharishi Markandeshwar Institute of Medical Sciences and Research Hospital, Mullana over 2 years from September 2020 to September 2022. One hundred cases of inactive, chronic otitis media (COM) were included in this study and subjected to Type 1 tympanoplasty with 50 belonging to the anterior tucking technique (Group A) and 50 to the anterior tunneling technique (Group B). Results: The graft uptake rate was 96% in Group A (anterior tucking technique) and 98% in Group B (anterior tunneling technique). The average hearing gain in Group A was 9.94 dB and in Group B was 9.36. Chances of complications like residual perforation were found to be low (4% in Group A and 2% in Group B) in both techniques. Conclusion: In our study, we concluded that both the techniques of anterior tucking and anterior tunneling of temporalis fascia graft in Type 1 tympanoplasty surgery are equally effective to achieve intactness of graft and hearing improvement in patients of inactive, mucosal COM.

Effect of cartilage tympanoplasty operation on compliance and hearing results

Aim: The purpose of this study was to investigate the effect of cartilage island grafts used in type 1 tympanoplasty surgery on compliance and hearing results.Methods: In this retrospective study, the medical records of patients who underwent type 1 tympanoplasty between May 2019 and December 2021 were reviewed. A total of 40 patients were included in the study. Preoperative audiological and tympanometry test results were compared with 6-month postoperative results. The effect of cartilage island graft on compliance and hearing levels was compared, preoperatively and postoperatively at the 6th-month follow-up.Results: Forty percent of patients were male, and 60% were female (n=24). The mean age of patients was 41,2±12.5 years. All postoperative tympanometry results showed a type B tympanogram tracing, as a result, no compliance was detected. At 500 Hz-4000 Hz frequencies, both air conduction hearing levels and air-bone gap thresholds showed a statistically significant improvement (p

Racial Disparities in Tympanoplasty Surgery: A 30-Day Morbidity and Mortality National Cohort Study.

To assess the impact of race and ethnicity on 30-day complications after tympanoplasty surgery. The National Surgical Quality Improvement Program database was queried for tympanoplasty procedures from 2005 to 2019. Demographic, comorbidity, and postoperative complication data were compared according to race using univariate and binary logistic regression analyses. A total of 11,701 patients were included, consisting of 80.3% White, 3.0% Black, 7.7% Asian, 5.7% Hispanic, 2.5% American Indian/Alaska Native, and 0.8% other. Binary logistic regression model indicated that Black patients had increased odds of unplanned readmittance (p = 0.033; odds ratio [OR], 3.110) and deep surgical site infections (p = 0.008; OR, 6.292). American Indian/Alaska Native patients had increased odds of reoperation (p = 0.022; OR, 6.343), superficial surgical site infections (p < 0.001; OR, 5.503), urinary tract infections (p < 0.001; OR, 18.559), surgical complications (p < 0.001; OR, 3.820), medical complications (p = 0.001; OR, 10.126), and overall complications (p < 0.001; OR, 4.545). Although Black and American Indian/Alaskan Native patients were more likely to have complications after tympanoplasty surgery after adjusting for comorbidities, age, and sex, these results are tempered by an overall low rate of complications. Future studies should be devoted to understanding the drivers of these health inequities in access to otologic care and surgical treatment to improve outcomes and achieve equitable care.

Hearing Evaluation Post Canal Wall-Up (CWU) Tympanoplasty on Patients with Safe Type Chronic Suppurative Otitis Media

Objective: Otitis media is a contagious inflammatory illness of the middle ear that might have a sudden onset and a complete resolution, or it can have a persistent presentation and long-term implications. Surgical treatment is available for all kinds of otitis media. Different types of operations include canal wall-up, canal wall-down, and their variations. The wall-up approach of the two canals with or without posterior tympanotomies, also known as tympanoplasty surgery, preserves the rear wall of the ear canal. Material and Methods: Hearing evaluation was conducted after canal wall-up tympanoplasty surgery at the outpatient clinic, Department of Otorhinolaryngology, Dr. Soetomo Hospital, Surabaya, Indonesia over a period of two years (2018-2019). Results: Two hundred and thirty-seven patients underwent from January 1, 2018 to December 31, 2019. However, only 74 (31.2%) of them had complete medical records after surgery. Fifty-nine ears (79.7%) experienced a better hearing threshold, six ears (8.1%) did not improve, and nine ears (12.2%) deteriorated. The hearing threshold improvement was of a magnitude of 10.9 dB; before surgery, it was 56.6 dB, and after surgery, it became 45.6 dB. Conclusion: A 10.9-dB improvement in hearing threshold mean was observed among patients undergoing canal wall-up tympanoplasty, whereas the bone gap improvement between pre- and post-tympanoplasty was 6.9 dB.

Evaluation of the use of autologous platelet-rich fibrin in myringoplasty operation

BackgroundPlatelet-rich fibrin (PRF) which is considered a second-generation platelet-rich plasma having a high content of growth factors could be implied as a sealant and adjuvant to grafting materials during tympanoplasty operation. This work aimed to evaluate the role of autologous platelet-rich fibrin as an adjuvant in type 1 tympanoplasty (myringoplasty) for the closure of central tympanic membrane perforations. A prospective comparative study was conducted including one-hundred patients with chronic suppurative otitis media with dry central TM perforations. The patients were classified into two equal groups: group A (case group) was subjected to myringoplasty operation with the use of autologous PRF added to the temporalis fascia graft, and group B (control group) was subjected to myringoplasty operation using graft only without PRF. Both groups were assessed for successful closure of perforation defined as an intact eardrum, success in terms of hearing defined as closure of air-bone gap down to 10 dB or lesser, and hearing gain at 6 months postoperatively.ResultsAt 6 months postoperatively, the success rate (graft taking) in group A (90%) was significantly higher than in group B (70%). Success in terms of air-bone gap closure (< 10 dB) revealed that in group A, success was achieved in 39 patients (78%), which was significantly higher than in group B 27 patients (54 %). Air-bone gap at 6 months postoperatively was more in the graft taken cases in the case group than in the control group with a significant difference. There was a nonsignificant correlation between graft uptake and either hemoglobin or platelet concentrations in both groups. In addition, there was a nonsignificant correlation between graft uptake and the size of the perforation in both groups.ConclusionPlatelet-rich fibrin is a cheap, cost-effective, and completely autologous platelet concentrate with enriched growth factors. It improves the overall success rate of myringoplasty with no noticeable side effects.

Endoscopic Versus Microscopic Pediatric Tympanoplasty: Is There a Difference Between Closure Rates and Hearing Outcomes?

To compare closure rates and hearing outcomes of microscopic and endoscopic tympanoplasty in pediatric patients. Retrospective chart review. Tertiary university medical center. Pediatric patients who underwent tympanoplasty surgery by a fellowship-trained neurotologist between 2010 and 2019 with a minimum of 2 months of follow-up, a tympanic membrane perforation, and no preoperative cholesteatoma. Transcanal endoscopic tympanoplasty or microscopic tympanoplasty (MT) surgery. The primary outcome is postoperative closure of the tympanic membrane perforation, assessed using otomicroscopy at the last follow-up appointment. Secondary outcomes include operative time and changes in the air-bone gap (ABG) and pure-tone average (PTA). Two hundred eleven tympanoplasty operations were analyzed: 121 in the transcanal endoscopic ear surgery (TEES) group and 90 in the MT group. Tympanic membrane closure rates were no different between the two groups (TEES, 82.6%; MT, 88.9%; p = 0.24), and no significant association was found on multivariable analysis (TEES: odds ratio, 0.8; p = 0.61). Both groups showed improvements in the 4-month PTA and ABG and the 12-month PTA, but the 12-month ABG only improved in the TEES group ( p < 0.01). The TEES group had a shorter average operative time (109.8 versus 123.5 min; p = 0.03) and less need for a postauricular incision (2.5% versus 93.3%; p < 0.01). In pediatric tympanoplasty, TEES gives similar membrane closure and hearing outcomes as the microscopic technique, with less operative time and less need for a postauricular incision.