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A comparison of endoscopic transtympanic myringoplasty and endoscopic type I tympanoplasty for repairing medium- to large-sized tympanic membrane perforation: a randomized clinical trial

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 24 July 2020

Abstract

Introduction

Endoscopic type I tympanoplasty (ETT) is currently accepted as an effective, minimally traumatic procedure for repairing tympanic membrane perforation. However, ETT requires tympanomeatal flap elevation which chorda tympani nerve injury, bleeding and wound healing are the drawbacks of this technique. Thus endoscopic transtympanic myringoplasty (ETM) without elevation of the tympanomeatal flap is commonly used as an alternative technique. This study aimed to compare the efficacy of ETM versus ETT for repairing medium- to large-sized perforation of the tympanic membrane.

Methods

The study cohort comprised patients undergoing surgery for medium- to large-sized perforation of the tympanic membrane between February 2018 and February 2019. The patients were randomized into the ETM group and the ETT group. The main outcomes were the graft take rates and hearing results. Secondary outcomes were the operative time, visual analog scale (VAS) pain scores, and postoperative complications.

Results

Forty patients who completed 6 months of follow-up were included, comprising 21 patients in the ETM group and 19 in the ETT group. The overall graft take rates for the ETM and ETT groups were 95.2% and 89.5%, respectively (P = 0.59). The graft take rates for patients in the ETM group with large-sized tympanic membrane perforation was 88.9%. There was a significantly higher rate of good hearing result in the ETM group (95.2% versus 68.4%) (P = 0.04). The ETM group had significantly shorter operative times than the ETT group (P < 0.01).

Conclusion

Our results demonstrated that the surgical outcome of ETM is comparable to that of ETT. However, ETM is less invasive and has a shorter operative time than ETT, and is suitable for simple perforation repair, regardless of the perforation size.

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Acknowledgements

We thank Mrs. Nannapat Pruphetkeaw for her assistance with data analysis and Kelly Zammit, BVSc, from Edanz Editing (www.edanzediting.com/ac), for editing a draft of this manuscript.

Funding

The research was supported by a grant from the Faculty of Medicine, Prince of Songkla University.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand

    Viraporn Atchariyasathian, Rata Suwannajak, Yuvatiya Plodpai & Pittayapon Pitathawatchai

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  1. Viraporn Atchariyasathian
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  2. Rata Suwannajak
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  3. Yuvatiya Plodpai
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  4. Pittayapon Pitathawatchai
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Correspondence to Viraporn Atchariyasathian.

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The authors have no conflict of interest to declare.

Ethical approval

The Ethic Committee at Faculty of Medicine, Prince of Songkla University approved the study protocol. The reference number of the study approval was REC 60-215-13-1. The trial was retrospectively registered at the Thai Clinical Trials Registry on 26 February 2020. The trial registration number is TCTR20200227001. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Atchariyasathian, V., Suwannajak, R., Plodpai, Y. et al. A comparison of endoscopic transtympanic myringoplasty and endoscopic type I tympanoplasty for repairing medium- to large-sized tympanic membrane perforation: a randomized clinical trial. Eur Arch Otorhinolaryngol 277, 2199–2207 (2020). https://doi.org/10.1007/s00405-020-05955-3

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  • DOI: https://doi.org/10.1007/s00405-020-05955-3

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