Endoscopic Myringoplasty: Advantages and Potential Drawbacks after A 8-Year Mono Institutional Experience

Villari, Domenico¹; Fermi, Matteo¹; Maccarrone, Francesco¹; Ghirelli, Michael¹; Ciufelli, Matteo Alicandri¹; Bonali, Marco¹; Presutti, Livio¹
1 Azienda Ospedaliera Universitaria Policlinico di Modena, Otolaryngology Head and Neck Department, Italy

Introduction:
The aim of the present study is to evaluate benefits and drawbacks of endoscopic transcanal tympanoplasty for tympanic perforations, especially in case of disadvantageous anatomy of the external auditory canal.

Methods:
Study Design: Retrospective chart review

Setting: Tertiary care referral center

Patients:The study involved 100 patients (45 males, 55 females), the mean age was 34,2 years old. We classified the perforations according to the quadrant/s involved and the percentage of perforated membrane surface. The presence of the fibrous annulus was evaluated.

Intervention(s): Transcanal endoscopic myringoplasties with underlay, overlay and mixed techniques has been considered eligible for the present study.

Discussion:
Main Outcome Measure(s): Functional outcome (PTA AC, PTA BC, ABG and ABG closure), definitive closure rate, perioperative and postoperative complications, duration of intervention and hospitalization.

Results: The success rate at the first follow-up was 88%. The ABG closure was 9,5, the post-operative ABG mean was 10.5. The larger perforations and those with the involvement of the annulus showed the worst results. Relapses occurred more frequently in reconstructions with soft materials. We had no complications. The average duration of intervention was 77,8 minutes. The average duration of hospitalization was 1,07 days.

Conclusions:
Our study shows that the percentage of surgical success and the functional results of endoscopic myringoplasties are comparable to those described for microscopic ones for the repair of tympanic perforations. However, the endoscopic procedure is less invasive as it avoids retroauricular incision and canalplasty, reduces postoperative pain, complications and allows faster recovery with a reduction in healthcare costs.