Outcomes of Endoscopic Tympanoplasty

By June 10, 2019

Sajjadi, A.1; Sayyid Z.2; Vaisbuch, Y.2; Sajjadi, H.2
1  Creighton University School of Medicine
2  Stanford University Department of Otolaryngology-HNS

This is a study of endoscopic tympanoplasty with or without mastoidectomy.
– Study Design: retrospective case review
– Setting: private and tertiary referral centers
– Patients: 155 endoscopic cases that were treated by a single otologist between 2014-2018; 85% male; average age at time of surgery: 57.1 years
– Intervention(s):  endoscopic tympanoplasty with or without mastoidectomy
– Main Outcome Measure(s)
: post-operative healing and perforation closure
We report the outcomes of 155 patients that underwent endoscopic tympanoplasty. 65.4% of patients presented with hearing loss, 47.4% with perforation of the tympanic membrane, 46.2% with middle ear infection(s), 28.2% with cholesteatoma, and 19.2% with Eustachian tube dysfunction. 66.1% of procedures were type 1 tympanoplasties, 22.0% type 3, and 11.9% type 4. 36.7% of perforations were small or pinpoint (<5% perforation), 40.0% moderate (20-50%), 10.0% large (50-75), and 13.3% were subtotal to total perforations (90-100%). 64.0% of perforations were located anteriorly. Average follow up time was 14.5 months. 88.9% of tympanoplasties resulted in full or near-total closure of perforations. No major complications were noted. The most common minor complication was post-operative infection (22.5%), granulation tissue (15.0%) and poor wound healing/scar formation (10.0%).
In comparison to reported outcomes for microscopic tympanoplasties, our cohort showed a favorable rate of closure. The significant advantage is in outcomes of anterior perforations while using a transcanal approach and avoiding postauricular incisions.