Endoscopic transcanal myringoplasty:Is learning curve a myth?

Abstract

Objective: To investigate the feasibility of transcanal endoscopic myringoplasty in the hand of young beginner surgeons who had just completed the residency programme. Methods: In a three year period (August 2012 to August 2015), 44 ears in 42 patients were operated upon by a beginner surgeon through the transcanal endoscopic approach in a subdistrict level hospital located in the north western ranges of the Himalayan region. Results: Of the 42 patient, 19 were male and 23 female. The mean age was 26.23 years (range: 15–47 years). In 40 ears, complete perforation closure was achieved at six months (success rate: 90.9%). The mean air conduction PTA preoperatively was 40.84 dB HL and improved to 28.06 dB HL postoperatively (p < .001). The mean AB gap preoperatively was 22.40 dB, which improved to 9.1 dB postoperatively (p < .001). Conclusion: Endoscopic transcanal myringoplasty is safe and reliable even in young beginners' hands. Surgeons can consider endoscopic approach early in their careers without the fear of learning curve. The cost of endoscopic equipment is about one tenth as compared to open approach under a operating microscope, and an added advantage. Keywords: Endoscopic transcanal, Myringoplasty, Learning curve, Beginner