Endoscopic versus microscopic type-I cartilage tympanoplasty for anterior perforation – a comparative study

Shakya, Dipesh; Kc, Arun; Tamang, Nirmala; Nepal, Ajit

doi:10.1080/00016489.2020.1834616

Cited by 7 publications

(16 citation statements)

References 18 publications

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“…The duration of surgery was compared in 21 of these studies, 13 of which reported a shorter surgical time in the endoscopic technique. 14,16,[18][19][20][21][22][24][25][26][27][28][29][30][31][33][34][35][36] The postoperative recovery time and level of pain presented by patients were evaluated by nine retrospective studies, seven of which had a 39 Retrospective TEES may be an alternative to a postauricular approach for removal of cholesteatoma limited to the middle ear and/or the attic in children. 18 Retrospective Similar results for ET and MT approach without significant statistical differences.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic or Microscopic Tympanoplasty Advantages and Disadvantages: A Theory Domain Systematic Review

Bianchini

Berlitz

Mocelin

et al. 2022

Int Arch Otorhinolaryngol

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Introduction Tympanoplasty is a reparative surgery that has multiple indications. The aid of a microscope or an endoscope is necessary to carry out the procedure. The classic method utilizes the microscope; however, in the recent decades, the endoscope has been popular. Although many articles try to compare these two techniques, there is still no robust evidence that confirms the superiority of either technique. In the present work, we seek to perform a systematic review contribute with this. Objectives The present systematic review attempted to compare endoscopic and microscopic surgery techniques and to discover whether there would be superiority in the results of any of them, based on data currently available in the literature. Data Synthesis The objectives of the present review were organized according to the PICO planning and strategy adapted for systematic reviews. The inclusion and exclusion criteria were established aiming to select only select primary data. The main medical databases were searched using an optimized search string with appropriate descriptors. The searched databases were MEDLINE, LILACS, SciELO, and EMBASE. A total of 99 studies were selected and 38 were fully assessed after the inclusion criteria were applied. All included articles were reviewed by all authors and their results were discussed and summarized. Conclusion The endoscopic technique was shown to be a safer technique comparable in effectiveness to the use of microscopy. In addition, it provides possible advantages such as shortening the surgical time and better postoperative pain outcomes.

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Section: Resultsmentioning

confidence: 99%

Endoscopic or Microscopic Tympanoplasty Advantages and Disadvantages: A Theory Domain Systematic Review

Bianchini

Berlitz

Mocelin

et al. 2022

Int Arch Otorhinolaryngol

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“…Other studies using cartilage on type-I endoscopic tympanoplasty reported a closure rate of 91.3–94.4% [ 11 , 13 , 15 ]. These findings indicate that the use of cartilage is a good choice in terms of graft stability.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we believe that it is preferable to use retroauricular fascia or tragus perichondrium. Moreover, these previous reports [ 11 , 13 – 15 ] did not mention drilling of the anterior wall for good visualization. Although these reports stated that the field of view could be obtained by endoscopic surgery, we believe that in many cases, this is not sufficient.…”

Section: Discussionmentioning

confidence: 99%

“…Recent rapid improvements in endoscopic imaging technology have enabled transcanal endoscopic ear surgery (TEES) without microscope, and TEES has become a widely used approach to tympanic perforation [ 1 – 15 ]. Previous studies have reported the benefits of TEES, compared with those of a postauricular incision, which include decreased hospital stay [ 3 ], enhanced visualization of the operative field [ 4 – 6 ], operation time [ 8 – 11 ], and good cosmetic results [ 3 , 5 , 6 ]. These studies applied the underlay technique, although the grafts used varied from temporalis fascia, perichondrium, and cartilage.…”

Section: Introductionmentioning

confidence: 99%

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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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“…Twenty studies (60.6%) were undertaken in India, three studies (9.1%) in China, two studies (6.1%) each in Thailand and Bangladesh, and one study (3.0%) each in Korea, Nepal, Iraq, Italy, Egypt, and Pakistan. In terms of study design, 13 studies (11,19,20,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) were randomized and 20 (7)(8)(9)(10)12,13,18,21,22,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) were nonrandomized. The inclusion and exclusion criteria of all studies are summarized in Supplementary Content 3, http://links.…”

Section: Study Characteristicsmentioning

confidence: 99%

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

2023

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Objectives To compare postoperative tympanoplasty outcomes between active versus inactive otitis media (OM) patients with tympanic membrane perforation. Databases Reviewed Medline via PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for studies published from inception to March 1, 2023. Methods Studies of 15- to 60-year-old patients undergoing microscopic/endoscopic myringoplasty using underlay/overlay technique with reported postoperative mean hearing gain and graft uptake were included. Studies requiring simultaneous surgical procedures, reporting patients with comorbidities and with non-English full text articles were excluded. Articles were independently screened by two researchers with data extracted according to a predetermined proforma in Microsoft Excel. Cochrane risk-of-bias assessment was used for risk of bias evaluation of randomized studies and Risk of Bias in Nonrandomized Studies of Interventions for nonrandomized studies. Similar studies were pooled for meta-analysis using the inverse variance random effects model to calculate the mean difference and corresponding 95% confidence interval (CI) for mean hearing gain and DerSimonian and Laird random effects model for graft uptake. Results Thirty-three studies comprising 2,373 patients met the inclusion/exclusion criteria, seven were pooled for meta-analysis. Included articles showed inactive OM patients have higher average postoperative mean hearing gain of 10.84 dB and graft uptake of 88.7% compared to active OM patients (9.15 dB and 84.2%). Meta-analysis of mean hearing gain (MD, –0.76 dB; 95% CI, −2.11 to 0.60; p = 0.27, moderate certainty) and graft uptake (OD, 0.61; 95% CI, 0.34–1.09; p = 0.10, moderate certainty) have an overall p value >0.05. Conclusion There were no statistically significant differences in postoperative mean hearing gain and graft uptake between active and inactive OM patients undergoing tympanoplasty. Hence, tympanoplasty procedures should not be postponed solely because of patients' preoperative ear discharge status.

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Endoscopic versus microscopic type-I cartilage tympanoplasty for anterior perforation – a comparative study

Cited by 7 publications

References 18 publications

Endoscopic or Microscopic Tympanoplasty Advantages and Disadvantages: A Theory Domain Systematic Review

Endoscopic or Microscopic Tympanoplasty Advantages and Disadvantages: A Theory Domain Systematic Review

Endoscopic tympanoplasty type I using interlay technique

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

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