Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane perforations

Abstract

The endoscopic push-through technique for anterior tympanic membrane perforations is as effective as microscopic underlay myringoplasty; furthermore, it is less invasive and takes less operative time.

Comparison of endoscopic butterfly-inlay versus endoscopic push-through myringoplasty in repairing anterior perforations of the tympanic membrane

“…Although various grafting techniques and graft materials have been described for repairing anterior perforations of the tympanic membrane, graft uptake rates are relatively low in patients with anterior perforations of the tympanic membrane. 8,10–12 According to a recent literature review, Jalali et al . reported that cartilage graft with comparable audiometric outcomes offers a higher graft uptake rate compared with temporalis fascia.…”

“…Reported graft uptake rate ranges between 84.4 and 97.4 per cent in patients who underwent endoscopic push-through myringoplasty. 4,8,13,14 Kim et al . reported a perforation closure rate of 91.3 per cent in patients undergoing modified butterfly-inlay cartilage (comprising one side perichondrium as in our study) myringoplasty.…”

“…There have recently been noteworthy studies related to minimally invasive push-through tympanoplasty with comparable surgical and functional results in the treatment of anterior perforations of the tympanic membrane. 4,8 However, to the best of our knowledge, there is currently no study directly comparing the outcomes of these two minimally invasive techniques for repairing anterior perforations of the tympanic membrane.…”

Endoscopic Suspended Cartilage Myringoplasty for the Repair of Central Tympanic Membrane Perforation

“…The perichondrium graft is placed directly over the surface of the tympanic membrane and annulus. Because endoscopy provides an excellent view, allowing clear observation of the entire remnant tympanic membrane and middle ear structure, 3,4,13,14 this technique does not require elevation of the tympanomeatal flap.…”

How do you perform your tympanoplasty, endoscopically or microscopically?

“…An endoscopic transcanal surgery is suggested to provide adequate vision without a postauricular approach or canalplasty with comparable success rates in anterior TM perforations. [28][29][30] Eren et al [28] reported a 95.5% closure rate for anterior TM perforation with an improved airbone gap from 19.3±3.3 dB to 10.8±4.5 dB in 21 of 22 patients who underwent a cartilage butterfly myringoplasty with an endoscopic transcanal approach. El-Hennawi et al [30] compared endoscopic push-through myringoplasty (28 patients) and microscopic myringoplasty (28 patients) with a tragal cartilage perichondrial graft and reported that the endoscopic technique is as effective as a microscopic approach in terms of surgical success rates with less operative time and invasiveness.…”