European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 12, pp 3327–3333 | Cite as

Endoscopic transcanal versus conventional microscopic tympanoplasty in treatment of anterior tympanic membrane perforations

  • Secaattin GülşenEmail author
  • Mehmet Arıcı



To compare the surgical outcomes of endoscopic transcanal tympanoplasty (ETT) and conventional microscopic tympanoplasty (CMT) in repairing anterior tympanic membrane perforations (ATMPs).


We retrospectively analyzed the graft success rate, hearing outcomes, operative time, hospitalization period and complications in patients who underwent ETT and CMT between October 2015 and July 2018. In addition, the authors investigated whether anterior canal wall protrusion (ACWP) affects the graft success rate and operative time.


The graft success rates for ETT and CMT were 93.7% (30 out of 32 patients) and 91.4% (32 out of 35 patients), respectively (p = 0.640). There was no significant relationship between ACWP and graft success rates in either the endoscopic (p = 0.685) and microscopic (p = 0.894) group. The mean operative time was significantly shorter in the ETT group (37.2 ± 3.1 min) than in the CMT group (52.9 ± 9.2 min) (p < 0.001). Regarding operative time, there was no statistically significant difference between patients with and without ACWP (38.3 versus 36.3 min, respectively (p = 0.124)) in the ETT group. However, the mean operative time of patients with ACWP in the CMT group was significantly longer than patients without ACWP [62.3 versus 48.8 min, respectively (p < 0.001)].


ETT offering fewer complication rates and shorter duration of surgery may serve as a reasonable alternative to CMT in repairing ATMPs, with comparable graft success rates.


Tympanoplasty Endoscopic ear surgery Chondroperichondrial graft Tympanic membrane Perforation Anterior 



Assoc. Prof. Fatih Çelenk and Mehmet Karataş made great contributions in editing the intellectual content and proofreading of this paper; Assoc. Prof. Cem Bayraktar did the statistical analysis of data in the present study.



Compliance with ethical standards

Conflict of interest

The authors of present study declare that they have no conflict of interest.

Informed consent

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

Ethical approval

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.


  1. 1.
    Malhotra M, Varshney S, Malhotra R, Joshi P (2017) Indian perspectives on graft materials used for repair of tympanic membrane. J Clin Diagn Res 11(7):1–6Google Scholar
  2. 2.
    Tarabichi M (1999) Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol 108:39–46CrossRefGoogle Scholar
  3. 3.
    Panetti G, Cavaliere M, Panetti M, Marino A, Iemma M (2017) Endoscopic tympanoplasty in the treatment of chronic otitis media: our experience. Acta Otolaryngol 137(3):225–228CrossRefGoogle Scholar
  4. 4.
    Yiannakis CP, Sproat R, Iyer A (2018) Preliminary outcomes of endoscopic middle-ear surgery in 103 cases: a UK experience. J Laryngol Otol 132:493–496CrossRefGoogle Scholar
  5. 5.
    Güneri EA, Olgun Y (2018) Endoscope-Assisted cochlear implantation. Clin Exp Otorhinolaryngol 11(2):89–95CrossRefGoogle Scholar
  6. 6.
    Yadav SP, Aggarwal N, Julaha M, Goel A (2009) Endoscope-assisted myringoplasty. Singapore Med J 50:510–512PubMedGoogle Scholar
  7. 7.
    Bonali M, Anschuetz L, Fermi M, Villari D, Mariani GA, Manzoli L, Caversaccio M, Presutti L (2017) The variants of the retro- and hypotympanum: an endoscopic anatomical study. Eur Arch Otorhinolaryngol 274(5):2141–2148CrossRefGoogle Scholar
  8. 8.
    Coskun BU, Cinar U, Seven H, Ugur S (2006) The effects of the incision types in myringoplasty operations on cosmetics. Eur Arch Otorhinolaryngol 263:820–822CrossRefGoogle Scholar
  9. 9.
    Jako GJ (1967) Postaural versus endaural exposure in tympanoplasty. Laryngoscope 77:2022–2031CrossRefGoogle Scholar
  10. 10.
    El-Guindy A (1992) Endoscopic transcanal myringoplasty. J Laryngol Otol 106:493–495CrossRefGoogle Scholar
  11. 11.
    El-Hennawi DEM, Ahmed MR, Abou-Halawa AS, Al-Hamtary MA (2018) Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane perforations. J Laryngol Otol 132(6):509–513CrossRefGoogle Scholar
  12. 12.
    Tarabichi M (2010) Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg 62:6–24CrossRefGoogle Scholar
  13. 13.
    Ayache S (2013) Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol 270:853–860CrossRefGoogle Scholar
  14. 14.
    Iannella G, Magliulo G (2016) Endoscopic versus microscopic approach in stapes surgery: are operative times and learning curve important for making the choice? Otol Neurotol 37(9):1350–1357CrossRefGoogle Scholar
  15. 15.
    Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF (2016) endoscopic transcanal myringoplasty for anterior perforations of the tympanic membrane. JAMA Otolaryngol Head Neck Surg 142(11):1088–1093CrossRefGoogle Scholar
  16. 16.
    Lade H, Choudhary SR, Vashishth A (2014) Endoscopic vs microscopicmyringoplasty: a different perspective. Eur Arch Otorhinolaryngol 271(7):1897–1902CrossRefGoogle Scholar
  17. 17.
    Furukawa T, Watanabe T, Ito T, Kubota T, Kakehata S (2014) Feasibility and advantages of transcanal endoscopicmyringoplasty. Otol Neurotol 35(4):140–145CrossRefGoogle Scholar
  18. 18.
    Celik H, Samim E, Oztuna D (2015) Endoscopic “push-trough” technique cartilage myringoplasty in anterior tympanic membrane perforations. Clin Exp Otorhinolaryngol 8(3):224–229CrossRefGoogle Scholar
  19. 19.
    Dundar R et al (2014) Endoscopic versus microscopic approach to type 1 tympanoplasty in children. Int J Pediatr Otorhinolaryngol 78:1084–1089CrossRefGoogle Scholar
  20. 20.
    Kaya I et al (2017) Endoscopic versus microscopic type 1 tympanoplasty in the same patients: a prospective randomized controlled trial. Eur Arch Otorhinolaryngol 274(9):3343–3349CrossRefGoogle Scholar
  21. 21.
    Kuo CH, Wu HM (2017) Comparison of endoscopic and microscopic tympanoplasty. Eur Arch Otorhinolaryngol 274(7):2727–2732CrossRefGoogle Scholar
  22. 22.
    Dundar R, Bulut H, Guler OK, Yukkaldiran A, Demirtas Y, Lynal I et al (2015) Oval window temperature changes in an endoscopic stapedectomy. J Craniofac Surg 26:1704–1708CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyDr Ersin Arslan Training and Research HospitalGaziantepTurkey
  2. 2.Department of Otorhinolaryngology, Faculty of MedicineAdıyaman UniversityAdıyamanTurkey

Personalised recommendations