1 Department of Otology, Al Farabi ENT Clinic, Casablanca, Morocco
The posterior approach leading to external auditory canal to perform tympanoplasty, made the surgeon more aggressif for this kind of surgery.
We think that new procedures have to be described for EES.
Our retrospective study reviewed 235 cases of endoscopic tympanoplasty. All patients have dry perforations and We classify the holes in the ear drums in 4 types : Type 1 Partial perforation, Type 2 anterior perforation 2a with anterior drum remnant, 2b without anterior drum remnant, Type 3 total perforation, Type 4 perforation with retraction.
Only adult more than 16 years old have been included and only anatomic results are reported in this study.
The surgical procedure is accorded to the location of the perforation. Transcanalar endoscopic approach is performed in all cases included in this report. The standardized procedure is under-over with cartilage graft harvested from the tragus.
There was 106 men (45%) and 129 women (55%). The perforation was Type 1 in 82 cases (35%), type 2 in 68 cases (29%) separated in 2a for 41 cases and 2b for 27 cases, type 3 in 57 cases ( 24%), and type 4 in 28 cases ( 12%).
Anatomic success concern 219 cases (93%). The anatomic success, regarding to our classification, are thus distributed : Type 1 (81 cases- 98%) type 2a (38 cases – 92%) type 2b ( 22 cases – 81%) type 3 ( 51 cases – 89%)and Type 4 (27 cases – 96%).
The author described the procedure that leaves the anterior annulus in place, without the needing of an anterior flap for all situations. The results are satisfactory.