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Endoscopic Tympanoplasty with Local Anesthesia: Experience in Uruguay – World Congress on Endoscopic Ear Surgery

Endoscopic Tympanoplasty with Local Anesthesia: Experience in Uruguay

By June 8, 2019

Percovich, Jose1; Gratadoux, Camila1; Costas, Gustavo1.
1 Faculty of Medicina. Republic University. Hospital de Clinicas. Montevideo. Uruguay.

Introduction:
•In the endoscopic tympanoplasty we found a way to give our patients an effective treatment for chronic perforations, not limited by the size or topography
•Because we work in a public hospital we found difficulties to access an operating room with general anesthesia. That’s the reason why we need to perform local anesthesia surgeries on a regular basis.
•The main purpose of this work is to show our outcomes using this technique.

Methods:
•Retrospective review of medical records
•June 2015 to July 2018
•Primary eligibility criteria:

a)Diagnosis of chronic perforation of the tympanic membrane
b)Endoscopic tympanoplasty  with local anesthesia
c)Post surgery follow up
d)Pure tone audiometry pre and post surgery.

•Patients with no follow-up were excluded
•Surgical technique: endocanal without tympanomeatal flap
•Graft: tragal cartilage and perichondrium
•Anesthesia: injection of mepivacaine 2% + epinephrine, in the circumference of the osteocartilaginous junction.

Discussion:

N %
Gender Female 35 74
Male 12 26
Surgical technique With TMF 0 0
Without TMF 47 100
Graft results Incorporation 36 77
Lateralization 11 23
Audiometry results Improvement 34 72
No improvement 13 28

Conclusion:
•We found in endoscopic tympanoplasty with local anesthesia an effective treatment for the chronic perforations of the tympanic membrane with acceptable rate of success. Knowing that our access to general anesthesia is limited.
•So endoscopic tympanoplasty has turned out to be helpful especially in developing countries, because of the limited accessibility to general anesthesia.