Endoscopic tympanoplasty type I for tympanic perforations: analysis of prognostic factors

Fermi, Matteo; Maccarrone, Francesco; Villari, Domenico; Palermo, Filippo; Alicandri‐Ciufelli, Matteo; Ghirelli, Michael; Presutti, Livio; Bonali, Marco

doi:10.1007/s00405-020-06588-2

Cited by 8 publications

(5 citation statements)

References 25 publications

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“…Therefore, the results herein reported should be considered according to the scenario of the study. Studies carried out in university teaching hospitals tend to present poorer results ( Fermi et al., 2021 ). In line with current evidence, the overall results in this study mirror the learning environment and complexity of a tertiary teaching hospital ( Sirena et al., 2010 ; Salvador et al., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Success rates and predictors of outcomes of type I tympanoplasty performed by residents in a teaching tertiary hospital

Mangia,

Amadeu,

da Silva Oliveira

et al. 2023

Journal of Otology

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Section: Discussionmentioning

confidence: 99%

Success rates and predictors of outcomes of type I tympanoplasty performed by residents in a teaching tertiary hospital

Mangia,

Amadeu,

da Silva Oliveira

et al. 2023

Journal of Otology

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“…The available field of view for visual recognition may be inadequate for a successful surgery. This is important because the epithelial layer is detached from the inferior part of the TM; additionally, most perforations and postoperative reperforations are found in the anteroinferior quadrant of the TM [ 23 ], and anterior perforation is also considered as a poor prognostic factor for graft uptake because of difficulty in access and graft instability [ 13 , 14 ]. In other words, the cause of the high rate of anterior reperforation is presumably a technical problem.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic tympanoplasty type I using interlay technique

Takahashi

Motegi

Yamamoto

et al. 2022

J of Otolaryngol - Head & Neck Surg

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Background Tympanoplasty using the interlay technique has rarely been reported in transcanal endoscopic ear surgery, unlike the underlay technique. This is because many surgeons find it challenging to detach the epithelial layer of the tympanic membrane using only one hand. However, the epithelial layer can be easily detached from the inferior part of the tympanic membrane. Another key point is to actively improve anteroinferior visibility even if the overhang is slight because most perforations and postoperative reperforations are found in the anteroinferior quadrant of the tympanic membrane. We report the application of the interlay technique in endoscopic tympanoplasty type I for tympanic perforations. Methods We retrospectively reviewed the medical records of 51 patients who had undergone tympanoplasty using the interlay technique without ossiculoplasty between 2017 and 2020. We then compared the data with those of patients who underwent microscopic surgery (MS) using the underlay technique between 1998 and 2009 (n = 104). No other technique was used in each group during this period. Repair of tympanic membrane perforation and hearing outcomes were assessed for > 1 year postoperatively. Results The perforation sites were limited to the anterior, posterior, and anterior–posterior quadrants in 23, 1, and 27 ears, respectively. Perforations were closed in 50 of the 51 ears (98.0%), and the postoperative hearing was good (average air-bone [A-B] gap was 6.8 ± 5.8 dB). The surgical success rate for the repair of tympanic membrane perforation was not significantly different from the MS group (93.3%, P = 0.15). The average postoperative average A-B gap in the group that underwent the interlay technique was significantly different from that in the MS group (10.1 ± 6.6 dB, P < 0.01). Conclusion The interlay technique should be considered as one of the treatment methods in endoscopic surgery for tympanic perforations. Further study of the postoperative outcomes of this procedure should be conducted to establish the optimal surgical procedure for tympanic perforations. Trial registration: This study was retrospectively approved by the Institutional Review Board of the Jikei University, Tokyo, Japan (approval number: 32-205 10286). Video abstract

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“…Mohanty et al [ 12 ] reported better graft success rate and ABG closure ratio with use of cartilage graft compared with use of fascial graft. In the study by Fermi et al, [ 13 ] the graft material was found to be the main determinant of the outcomes of endoscopic perforation repair; the use of hard grafts (cartilage or cartilage-perichondrium composite) was found more protective than soft grafts (fascia and perichondrium) alone, with an overall success rate of 91.2%. In a meta-analysis by Tan et al, [ 11 ] use of cartilage increased the closure rate by 2.8% compared with fascia.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic closure of tympanic membrane anterior perforation using a strip-type chondroperichondrial graft

Liang

Chen

et al. 2022

Medicine

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Myringoplasty is a surgical procedure to reconstruct tympanic perforation. However, repair of anterior perforations is still challenging. To analyze the anatomical and hearing outcomes of myringoplasty with a new technique of chondroperichondrial graft via endoscopy, 23 adult patients were retrospectively analyzed. All patients had anterior perforations of tympanic membranes that were repaired with a composite strip-type cartilage-perichondrium graft through a total endoscopic transcanal approach. The anatomical graft success rate at postoperative 1 month was 86.96% (20/23) and reached 100% at the 6-and 12-month follow-up. Compared to the preoperative air conduction threshold (44.7 ± 13.56 dB) and air-bone gap (ABG) (22.35 ± 6.54 dB), the postoperative air conduction threshold and ABG decreased to 33.52 ± 10.88 dB and 12.52 ± 3.94 dB, respectively (P < .0001). Twenty-two (95.65%) patients had an ABG below 20 dB postoperatively. The mean ABG improvement in our cohort was 9.83 ± 5.00 dB. The functional graft success rate was 95.65% (22/23). The convenience, reliability, time, and labor savings accrued from the approach described here make it a good choice for repair of anterior perforation of tympanic membrane.

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Endoscopic tympanoplasty type I for tympanic perforations: analysis of prognostic factors

Cited by 8 publications

References 25 publications

Success rates and predictors of outcomes of type I tympanoplasty performed by residents in a teaching tertiary hospital

Success rates and predictors of outcomes of type I tympanoplasty performed by residents in a teaching tertiary hospital

Endoscopic tympanoplasty type I using interlay technique

Endoscopic closure of tympanic membrane anterior perforation using a strip-type chondroperichondrial graft

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