Chung, Jong Woo1; Kang, Woo Seok1
1 Department of Otorhinolaryngology-Head and Neck Surgery
Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
The procedures of the tympanoplasty consist of 1) preparation of the graft (fascia or perichondrium), 2) removal of the skin along the perforation margin, 3) inspection of the ossicular chain and eustachian tube, and 4) insertion of the graft material.
Generally, there are two methods for approaching middle ear: endocanal and transcanal techniques. Endocanal approach does not need the elevation of the tympanomeatal (TM) flap. The graft material will be pushed through the perforation with the previous filling of the middle ear with gel foams. Transcanal technique needs the elevation of a TM flap with an incision of the external ear canal around 6 to 12 o’clock position. A graft will be inserted through the posterior tympanum.
In one hand surgery using an endoscope, the endocanal technique is more comfortable in the insertion of graft material. However, it is difficult to observe the posterior end of the graft.
In this video, I am going to show the endoscopic tympanoplasty with endocanal technique and small transcanal incision.