Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T01:21:39.071Z Has data issue: false hasContentIssue false

The outcomes of endoscopic myringoplasty: elevating a tympanomeatal flap or not

Published online by Cambridge University Press:  28 September 2020

D Wang
Affiliation:
ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China Key Laboratory of Hearing Medicine, National Health and Family Planning Commission, Shanghai, China
W Wang*
Affiliation:
ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China Key Laboratory of Hearing Medicine, National Health and Family Planning Commission, Shanghai, China
*
Author for correspondence: Dr Wuqing Wang, ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University and Key Laboratory of Hearing Medicine of National Health and Family Planning Commission (NHFPC), Shanghai200031, China E-mail: [email protected]

Abstract

Objective

The aim of this study was to compare the differences between the no tympanomeatal flap approach and the tympanomeatal flap approach in endoscopic myringoplasty.

Method

A total of 132 patients with tympanic membrane perforation were randomly divided into two groups: the no tympanomeatal flap approach group (group A, 56 ears) and the tympanomeatal flap approach group (group B, 76 ears). A comparison between the two groups was made.

Results

The average operation time of group A was 36.00 ± 5.24 minutes, which was significantly shorter than that of group B, which was 43.89 ± 4.57 minutes (p = 0.002). The blood loss of group A was 5.08 ± 1.83 ml, which was significantly less than that of group B (9.67 ± 2.29 ml; p < 0.001). There were no differences in the degree of hearing improvement, the rate of hearing improvement, the dry ear time (when the external auditory canal and the operating cavity were dry) after operation and the success rate of tympanic membrane repair when compared between the two groups.

Conclusion

Compared with group B, group A (no tympanomeatal flap approach) can achieve the same effect but has the advantages of a shorter operation time and less blood loss during the operation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr W Wang takes responsibility for the integrity of the content of the paper

References

Wullstein, H. The restoration of the function of the middle ear, in chronic otitis media. Ann Otol Rhinol Laryngol 1956;65:1021–41CrossRefGoogle ScholarPubMed
Marchioni, D, Villari, D, Mattioli, F, Alicandri-Ciufelli, M, Piccinini, A, Presutti, L. Endoscopic management of attic cholesteatoma: a single-institution experience. Otolaryngol Clin North Am 2013;46:201–9CrossRefGoogle ScholarPubMed
Karchier, EB, Niemczyk, K, Orlowski, A. Comparison of visualization of the middle ear by microscope and endoscopes of 30° and 45° through posterior tympanotomy. Wideochir Inne Tech Maloinwazyjne 2014;9:276–81Google ScholarPubMed
Tarabichi, M, Nogueira, JF, Marchioni, D, Presutti, L, Pothier, DD, Ayache, S. Transcanal endoscopic management of cholesteatoma. Otolaryngol Clin North Am 2013;46:107–30CrossRefGoogle ScholarPubMed
Bennett, ML, Zhang, D, Labadie, RF, Noble, JH. Comparison of middle ear visualization with endoscopy and microscopy. Otol Neurotol 2016;37:362–6CrossRefGoogle ScholarPubMed
Pap, I, Id-Orcid, , Toth, I, Gede, N, Hegyi, P, Szakacs, Z et al. Endoscopic type I tympanoplasty is as effective as microscopic type I. Clin Otolaryngol 2019;44:13407CrossRefGoogle ScholarPubMed
Glikson, E, Yousovich, R, Mansour, J, Wolf, M, Migirov, L, Shapira, Y. Transcanal endoscopic ear surgery for middle ear cholesteatoma. Otol Neurotol 2017;38:41–5CrossRefGoogle ScholarPubMed
Kapadiya, M, Tarabichi, M. An overview of endoscopic ear surgery in 2018. Laryngoscope Investig Otolaryngol 2019;4:365–73CrossRefGoogle ScholarPubMed
Vincenti, V, Pasanisi, E, Bacciu, A, Bacciu, S. Long-term results of external auditory canal closure and mastoid obliteration in cochlear implantation after radical mastoidectomy: a clinical and radiological study. Eur Arch Otorhinolaryngol 2014;271:2127–30CrossRefGoogle ScholarPubMed
Tseng, CC, Lai, MT, Wu, CC, Yuan, SP, Ding, YF. Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: a systematic review and meta-analysis. Laryngoscope 2017;127:1890–6CrossRefGoogle ScholarPubMed
Bajin, MD, Yilmaz, T, Gunaydin, RO, Kuscu, O, Sozen, T, Jafarov, S. Management of acquired atresia of the external auditory canal. J Int Adv Otol 2015;11:147–50CrossRefGoogle ScholarPubMed
Karkas, A, Badidi, G, Odinet, P, Reynard, P, Martin, C. Acquired medial external auditory canal stenosis, anterior tympanomeatal angle blunting, and lateralized tympanic membrane: nosology, diagnosis, and treatment. Eur Ann Otorhinolaryngol Head Neck Dis 2019;136:93–7CrossRefGoogle ScholarPubMed
Sperling, NM, Kay, D. Diagnosis and management of the lateralized tympanic membrane. Laryngoscope 2000;110:1987–93CrossRefGoogle ScholarPubMed
Shea, JJ. Vein graft closure of eardrum perforations. Northwest Med 1960;59:770–2Google ScholarPubMed
Singh, GB, Sharma, A, Singh, N. Role of transtympanic myringoplasty in modern otology. J Otolaryngol 2006;35:408–12CrossRefGoogle ScholarPubMed
Alzoubi, FQ, Tarifi, AA, Khader, Y, de Carpentier, J. Comparison between transtympanic and elevation of tympanomeatal flap approaches in tympanoplasty. Otol Neurotol 2010;31:773–5CrossRefGoogle ScholarPubMed
Raj, A, Meher, R. Endoscopic transcanal myringoplasty–a study. Indian J Otolaryngol Head Neck Surg 2001;53:47–9CrossRefGoogle ScholarPubMed
Tseng, CC, Lai, MT, Wu, CC, Yuan, SP, Ding, YF. Endoscopic transcanal myringoplasty for anterior perforations of the tympanic membrane. JAMA Otolaryngol Head Neck Surg 2016;142:1088–93CrossRefGoogle ScholarPubMed
Tseng, CC, Lai, MT, Wu, CC, Yuan, SP, Ding, YF. Comparison of endoscopic transcanal myringoplasty and endoscopic type I tympanoplasty in repairing medium-sized tympanic perforations. Auris Nasus Larynx 2017;44:672–7CrossRefGoogle ScholarPubMed
Tseng, CC, Lai, MT, Wu, CC, Yuan, SP, Ding, YF. Endoscopic transcanal myringoplasty for tympanic perforations: an outpatient minimally invasive procedure. Auris Nasus Larynx 2018;45:433–9CrossRefGoogle ScholarPubMed