Endoscopic Tympanoplasty Using Tragal Cartilage Perichondrium: Elevated versus Non-Elevated Tympanomeatal Flap

Abstract

Background: Tympanoplasty aims to restore hearing by fixing a perforated eardrum. This procedure can be carried out using various techniques and tissue grafts. While there is no agreement on the specific technique or graft to be used, the surgeon's experience and preferences are crucial in determining which repair method to select. Endoscopy allows for sufficient visualization, and even if there are exostoses [bony growths] in the external auditory canal [EAC], the margins of the perforation can be distinctly assessed.Aim of the work: This study aims to compare two surgical techniques of endoscopic type 1 tympanoplasty; Trans canal with or without tympanomeatal flap elevation.Patients and Methods: Fifty-two Patients with tympanic perforation attending Al-Azhar University Hospital, Otorhinolaryngology outpatient clinic with chronic tympanic membrane perforation and they were divided into two equal groups: Tympanoplasty with and without Elevation of Tympanomeatal Flap. The main studied outcomes were success rate of surgery and improvement of hearing.Results: We found significant decrease in post-operative Air Bone gap in group A than group B [p=0.015]. Mean operative time was statistically significant lower operative time in group B than group A [p=0.001]. High success rate was reported in both group without statistically significant difference.Conclusion: The trans-tympanic tympanoplasty is a straightforward method that has success rates similar to those of the tympanomeatal flap technique.

Keywords

• endoscopic
• tympanoplasty
• tragal cartilage
• tympanomeatal flap