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Endoscopic tympanoplasty type I for tympanic perforations: analysis of prognostic factors

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

Abstract

Purpose

To assess the anatomical and functional outcomes of endoscopic transcanal tympanoplasty type I for tympanic membrane perforations.

Methods

Eight hundred thirty-five patients who underwent tympanoplasty between January 2011 and January 2019 were selected. Patients with tympanic membrane perforation treated with a transcanal endoscopic tympanoplasty type 1 and a follow-up period longer than 6 months have been retrospectively reviewed. The presence of cholesteatoma or ossicular chain dysfunctions were considered exclusion criteria. Eighty-one patients were included in the present study population. The main outcome was the rate of overall graft success. Secondary outcomes included hearing results. Prognostic factors related to both the abovementioned outcomes were assessed.

Results

Overall, 66 patients (81.5%) had a successful graft at the last follow-up evaluation. Mean follow-up was 22.1 (range 6–104) months. The anterior quadrants were entailed by the perforation in 62 (76.5%) cases. The overall success rate with cartilage (or cartilage and perichondrium) was 91.2% (p < 0.01). The median preoperative and postoperative ABG were 18.7 (13.4–25.6) and 7.5 (2.5–12.5), respectively, revealing a significant median improvement of 11.2 (p < 0.001). The type of graft and the postoperative tympanic membrane status were significantly associated with the audiologic outcome with p = 0.01 and p = 0.02, respectively.

Conclusions

Endoscopic tympanoplasty type I is a reliable technique with reasonable anatomic and audiologic results. Tympanic membrane grafting with cartilage (or cartilage and perichondrium) guarantees a higher rate of perforation closure and satisfactory hearing results. Anterior eardrum perforations can be successfully and safely managed with transcanal endoscopic approach avoiding postauricular approach and canalplasty.

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Acknowledgements

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Authors and Affiliations

  1. Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy

    Matteo Fermi, Francesco Maccarrone, Domenico Villari, Matteo Alicandri-Ciufelli, Michael Ghirelli, Livio Presutti & Marco Bonali

  2. Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy

    Filippo Palermo

Authors
  1. Matteo Fermi
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  2. Francesco Maccarrone
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  3. Domenico Villari
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  4. Filippo Palermo
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  5. Matteo Alicandri-Ciufelli
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  6. Michael Ghirelli
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  7. Livio Presutti
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  8. Marco Bonali
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Contributions

Conception and design: MF, FM, DV, MA-C, MB; acquisition of data: MF, FM, MG, FP; analysis and interpretation of data: MF, FM, FP, DV; drafting the article: MF, FM, MG. Critically revising the article: DV, MA-C, LP, MB; review submitted version of manuscript: DV, MA-C, MB; approved the final version of the manuscript on behalf of all authors: MB. Study supervision: DV

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Correspondence to Francesco Maccarrone.

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The authors declare no conflict of interest.

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Our Institutional Review Board did not require any approval for retrospective chart reviews. The study has been performed according to the Declaration of Helsinki.

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Fermi, M., Maccarrone, F., Villari, D. et al. Endoscopic tympanoplasty type I for tympanic perforations: analysis of prognostic factors. Eur Arch Otorhinolaryngol 278, 4715–4722 (2021). https://doi.org/10.1007/s00405-020-06588-2

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  • DOI: https://doi.org/10.1007/s00405-020-06588-2

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