A Study of Large Number of Patients on Advantages of Transcanal Endoscopic Myringoplasty
Takatoshi Furukawa; Tsukasa Ito; Toshinori Kubota; Hirooki Matsui; Takanari Goto; Seiji Kakehata
Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Japan
Objective: A simple underlay myringoplasty (SUM) using fibrin glue has been introduced broadly in Japan, and endoscopic SUM and transcanal endoscopic myringoplasty with intracanal incision (TEM) has become our first choice from 2011. Our previous reports of endoscopic transcanal myringoplasty in 2014 were limited by their small numbers. Now the number of our transcanal endoscopic myringoplasty has become over 100 and we investigated feasibility and treatment results of transcanal endoscopic myringoplasty.
Patients: Transcanal endoscopic myringoplasty was performed on 164 ears in 152 patients between 2011 and 2017.
Intervention: A preoperative endoscopic view and a microscopic view were obtained for the same patient and compared. Success rates among operation type, perforation size, causes of perforation and age were examined. Rates of canalplasty procedure and hearing results were also examined.
Results: The anterior edge of the perforation was not visible under microscopy in 15.9% preoperatively. Endoscopic views, however, revealed the entire image of the tympanic membrane in one field. The overall success rate for perforations was 89.6% and our success rates were almost same regardless of the operation type, perforation size, causes of perforation and age. Canalplasty was needed in 2.4%. The averaged reduced air bone gaps were 9.1dB.
Conclusion: A comparison of endoscopic and microscopic views revealed that the endoscopic approach produces superior visualization in comparison with microscopic transcanal myringoplasty. Our results demonstrate that transcanal endoscopic myringoplasty can produce stable perforation closure rates regardless of the side, gender, age, cause and number of quadrants and reduce rates of canalplasty procedure.