Microscopic versus Endoscopic Inlay Butterfly Cartilage Tympanoplasty

Lee, Se A; Kang, Hyun Tag; Lee, Yun Ji; Kim, Bo Gyung; Lee, Jong Dae

doi:10.7874/jao.2018.00549

Cited by 19 publications

(15 citation statements)

References 15 publications

(22 reference statements)

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“…In view of the audiological outcome, the mean AC threshold and ABG improved significantly regardless of the perforation size and location. A significant correlation between the preoperative size of the TM perforation and the postoperative ABG was reported in a recent study [16], and it was easy to predict that the patients with larger perforations would show bigger postoperative ABGs. To evaluate the exclusive effect of FGM among different size and location groups, we analyzed our hearing gain of FGM based on “ABG improvement” rather than postoperative ABG.…”

Section: Discussionmentioning

confidence: 97%

“…FGM and inlay butterfly cartilage tympanoplasty is one of the alternative options for conventional tympanoplasty [15, 16]. Compared to inlay butterfly cartilage tympanoplasty, which usually uses tragal cartilage as a graft material, FGM is relatively less invasive, and fat has some advantages in that it can be harvested easily and several times, unlike tragal cartilages.…”

Section: Discussionmentioning

confidence: 99%

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The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

Han

Park

et al. 2020

ORL

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Background/Aims: This study was conducted to evaluate the long-term stability of fat-graft myringoplasty (FGM) for chronic tympanic membrane perforations, analyzing the perforation closure rate and re-gained hearing outcome with respect to the size and location of the perforations. Methods: Between August 2007 and June 2018, a total of 193 patients who underwent FGM due to chronic tympanic membrane perforation at a tertiary referral center were enrolled and analyzed. Results: The mean follow-up was 14.6 months (range 6–39). The complete perforation closure rate after FGM was 89.6%, with no statistical difference among the perforation size groups. The mean postoperative air-bone gap (ABG) was 11.0 dB and mean ABG improvement was 4.9 dB. Conclusion: Our FGM technique had a favorable tympanic closure rate for small to large perforations, and yielded relatively good hearing improvement in the mid-size perforation cases over long-term follow-up periods. According to the topographic evaluation of FGM, this procedure resulted in a reliable perforation closure rate and audiological results regardless of the perforation site.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

Han

Park

et al. 2020

ORL

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“…The baseline characteristics of the included studies are presented in Table 1. The 43 studies enrolled a total of 3712 patients who received type I tympanoplasty 17‐59 . The follow‐up duration ranged from 3 to 23.2 months.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Versus Microscopic Type I Tympanoplasty: An Updated Systematic Review and Meta‐analysis

Wang,

Shih,

Chen

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveOur objective was to perform a systematic review and meta‐analysis comparing the clinical outcomes after endoscopic and microscopic type I tympanoplasty.Study DesignRandomized controlled trials, two‐arm prospective studies, and retrospective studies were included.SettingMedline, Cochrane, EMBASE, and Google Scholar databases were searched until March 1, 2022 using the combinations of search terms: “endoscopic,” “microscopic,” and “tympanoplasty.”MethodsTwo independent reviewers utilized the abovementioned search strategy to identify eligible studies. If any uncertainty existed regarding eligibility, a third reviewer was consulted. Primary outcome measures were graft success rate, air‐bone gap (ABG) improvement, and operative time. Secondary outcomes were the rate of need for canalplasty, the proportion of self‐rated excellent cosmetic results, and pain visual analog scale (VAS).ResultsForty‐three studies enrolled a total of 3712 patients who were undergoing type I tympanoplasty and were finally included. The pooled result showed endoscopic approach was significantly associated with shorter operative time (difference in means: −20.021, 95% confidence interval [CI]: −31.431 to −8.611), less need for canalplasty (odds ratio [OR]: 0.065, 95% CI: 0.026‐0.164), more self‐rated excellent cosmetic results (OR: 87.323, 95% CI: 26.750‐285.063), and lower pain VAS (difference in means: −2.513, 95% CI: −4.737 to −0.228). No significant differences in graft success rate or ABG were observed between the two procedures.ConclusionEndoscopic type I tympanoplasty provides a similar graft success rate, improvement in ABG, and reperforation rate to microscopic tympanoplasty with a shorter operative time, better self‐rated cosmetic results, and less pain. Unless contraindicated, the endoscopic approach should be the procedure of choice in type I tympanoplasty.

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“…James (6) looked at the outcomes of 250 pediatric patients and found an overall closure rate of 88%, again with no difference between the TEES and MT groups. Multiple studies that look at both pediatric and adult patients have found similar closure rates between 72 and 97% (7–12), with no differences between TEES and MT.…”

Section: Discussionmentioning

confidence: 96%

Endoscopic Versus Microscopic Pediatric Tympanoplasty: Is There a Difference Between Closure Rates and Hearing Outcomes?

et al. 2022

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Objective: To compare closure rates and hearing outcomes of microscopic and endoscopic tympanoplasty in pediatric patients. Study Design: Retrospective chart review. Setting: Tertiary university medical center. Patients: Pediatric patients who underwent tympanoplasty surgery by a fellowship-trained neurotologist between 2010 and 2019 with a minimum of 2 months of follow-up, a tympanic membrane perforation, and no preoperative cholesteatoma. Interventions: Transcanal endoscopic tympanoplasty or microscopic tympanoplasty (MT) surgery. Main Outcome Measures: The primary outcome is postoperative closure of the tympanic membrane perforation, assessed using otomicroscopy at the last follow-up appointment. Secondary outcomes include operative time and changes in the air-bone gap (ABG) and pure-tone average (PTA). Results: Two hundred eleven tympanoplasty operations were analyzed: 121 in the transcanal endoscopic ear surgery (TEES) group and 90 in the MT group. Tympanic membrane closure rates were no different between the two groups (TEES, 82.6%; MT, 88.9%; p = 0.24), and no significant association was found on multivariable analysis (TEES: odds ratio, 0.8; p = 0.61). Both groups showed improvements in the 4-month PTA and ABG and the 12-month PTA, but the 12-month ABG only improved in the TEES group ( p < 0.01). The TEES group had a shorter average operative time (109.8 versus 123.5 min; p = 0.03) and less need for a postauricular incision (2.5% versus 93.3%; p < 0.01). Conclusion:In pediatric tympanoplasty, TEES gives similar membrane closure and hearing outcomes as the microscopic technique, with less operative time and less need for a postauricular incision.

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Microscopic versus Endoscopic Inlay Butterfly Cartilage Tympanoplasty

Cited by 19 publications

References 15 publications

The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

Endoscopic Versus Microscopic Type I Tympanoplasty: An Updated Systematic Review and Meta‐analysis

Endoscopic Versus Microscopic Pediatric Tympanoplasty: Is There a Difference Between Closure Rates and Hearing Outcomes?

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