Endoscopic cartilage tympanoplasty: A two‐handed technique using an endoscope holder

Khan, Mubarak Muhamed; Parab, Sapna Ramkrishna

doi:10.1002/lary.25760

Cited by 67 publications

(32 citation statements)

References 14 publications

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“…The graft‐failure rate ranged from zero to 13.6%, which was similar to that of MES . The recurrence rate of cholesteatoma after EES in this study was similar to that of MES (4%–15%) . A few studies evaluated the efficacy of EES for intraoperative detection of residual cholesteatoma .…”

Section: Discussionsupporting

confidence: 70%

Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta‐analysis

et al. 2018

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Objectives Recently, the endoscope has been increasingly introduced for middle‐ear surgery. To evaluate the postoperative outcomes of endoscopic ear surgery (EES) in pediatric patients, we did a qualitative analysis with a systematic review and quantitative analysis with meta‐analysis of available literature. Methods Studies reporting the comparative surgical outcomes of EES in pediatric patients were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases from database inception through 2017. The selected articles included clinical studies conducted with at least 30 subjects and at least one postoperative parameter, including residual or recurrent cholesteatoma and graft success in tympanoplasty. Two investigators independently reviewed all studies and extracted the data using a standardized form. A meta‐analysis was performed using a random‐effects model and qualitative review was performed on the smaller studies. Results Ten studies were identified as appropriate for quantitative meta‐analysis and 19 studies for qualitative analysis. In the meta‐analysis, residual or recurrence rate of cholesteatoma was significantly lower in the EES group than in the microscopic ear surgery (MES) group (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.38‐0.84, P = .005). The graft success rate of tympanoplasty was not statistically different between EES and MES groups (OR: 0.72, 95% CI: 0.41‐1.26, P = .249). In the qualitative analysis, most of the studies reported similar audiological outcomes after tympanoplasty and success rate of cholesteatoma removal between the two groups. Conclusions It appears that EES reduces the risk of residual cholesteatoma in children and that the success of perforation closure is equivalent to MES. Laryngoscope, 129:1444–1452, 2019

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Section: Discussionsupporting

confidence: 70%

Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta‐analysis

et al. 2018

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“…11,12 There are many advantages of endoscopic technique but still it has some limitations like, one handed surgery by endoscope having difficulty in suction of blood from the operative field and heat generation from endoscope during surgery can damage external auditory canal and middle ear structure. However recently two-handed endoscopic technique innovated by Khan et al 13 to minimized heat related damage Kozinet et al 14 recommended using sub maximal light intensity and frequent repositioning of endoscope.…”

Section: Discussionmentioning

confidence: 99%

Microscopic Tympanoplasty Versus Endoscopic Tympanoplasty: A Comparative Study in a Tertiary Care Centre of West Bengal

Haldar¹,

Pervej²

2019

jebmh

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BACKGROUND Chronic otitis media is one of the most common health problems of our country. Perforation in their tympanic membrane and hearing loss are the presenting feature of chronic otitis media. Reconstruction of the hearing mechanism can be done by surgical procedure namely tympanoplasty. This study is being conducted to compare the success rate of tympanoplasty regarding graft uptake, hearing improvement and also to assess the advantage and disadvantage of endoscope and microscope during surgery. MATERIALS AND METHODS This randomized prospective study was conducted in Malda Medical College between August 2015 to July 2018. In this study, 60 patients of chronic otitis media with dry perforation for at-least 3 weeks, in the age group 16-49 years were divided into two equal groups of 30 each. First group underwent type 1 tympanoplasty by microscope and another group underwent type 1 tympanoplasty by endoscope. Data was collected from above patients and statistically analysed regarding graft taken or rejected and hearing improvement. RESULTS This study included 60 patients, 30 patients in each group. Success rate regarding the drum closure in endoscopic group is 86.66%, whereas in microscopic group it was 83.33%. Post-operative A-B gap improvement is also little better in endoscopic group than microscopic group. In endoscopic technique, one patient had medialisation of graft postoperatively. We got one case of medialisation and another case of lateralisation of graft in microscopic method postoperatively. CONCLUSION Endoscope is better for closure of perforated tympanic membrane than microscope because of better field of vision.

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“…Similarly, in this study it is suggested that taking out the endoscope from external auditory canal and cooling it with irrigation plays an important role to avoid thermal damage. Khan and Parab [ 10 ] described an endoscope holder-assisted transcanal two-handed endoscopic tympanoplasty procedure with better surgical outcomes and they suggested that some simple techniques like irrigation should be used during surgery to prevent thermal damage. According to the findings of this study if the surgeon pays attention to aforementioned precautions, these instruments could be safely used in otologic procedures with short duration.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Endoscopic Tympanoplasty on Cochlear Function

Kaya

Turhal²,

Öztürk

et al. 2018

Clin Exp Otorhinolaryngol

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Objectives The aim of this prospective clinical study was to measure the audiologic outcomes of the patients that underwent endoscopic transcanal cartilage tympanoplasty, and to investigate the effects on cochlear function.Methods Thirty-three patients (33 ears) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic transcanal cartilage tympanoplasty technique were included. Pre- and postoperative first month distortion product otoacoustic emission (DPOAE) signal-to-noise ratio (SNR), bone conduction hearing levels and air bone gap (ABG) values were measured and total endoscope usage time was noted.Results Preoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (1–11; interquartile range [IQR], 1), 6 dB (4–20; IQR, 1), 7 dB (3–26; IQR, 5) and 5.50 dB (0–9; IQR, 3), respectively. Postoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (3–9; IQR, 1), 6 dB (2–21; IQR, 3), 7 dB (2–20; IQR, 3), and 6 dB (0–10; IQR, 7), respectively. Regarding the DPOAE measurements, there was no statistically significant difference between the SNR values of all given frequencies (P>0.05). Regarding the pure tone audiometry (PTA) measurements, bone conduction was significantly better at 0.5 and 1 kHz, postoperatively (P<0.05) and there was statistically significant difference at 2 and 4 kHz (P>0.05). Additionally, no statistically significant correlation was found between the SNR and PTA measurements and the endoscope usage time (P>0.05).Conclusion We suggested that cochlear functions and sensorineural hearing remained stable after endoscopic transcanal cartilage tympanoplasty and cold light source doesn’t cause significant adverse effects cochlear functions.

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Endoscopic cartilage tympanoplasty: A two‐handed technique using an endoscope holder

Abstract: 4. Laryngoscope, 126:1893-1898, 2016.

Cited by 67 publications

References 14 publications

Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta‐analysis

Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta‐analysis

Microscopic Tympanoplasty Versus Endoscopic Tympanoplasty: A Comparative Study in a Tertiary Care Centre of West Bengal

The Effect of Endoscopic Tympanoplasty on Cochlear Function

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