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Review of Transcanal Endoscopic Ear Surgery (TEES) and Bioengineering for Pediatric Otologic Surgery. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00417-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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The Pretragal Superficial Musculoaponeurotic System Fascia: A New Graft Material for Transcanal Tympanoplasty. Otol Neurotol 2021; 41:644-653. [PMID: 32080032 DOI: 10.1097/mao.0000000000002599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare outcomes of transcanal endoscopic tympanoplasty reconstructed using pretragal superficial musculoaponeurotic system (SMAS) fascia versus temporalis fascia. STUDY DESIGN Retrospective patient review and posttreatment questionnaire survey. SETTING Tertiary referral center. PATIENTS Sixty adult patients with chronic dry tympanic membrane perforation. INTERVENTIONS Patients underwent transcanal endoscopic type I tympanoplasty reconstructed using the SMAS fascia between September 2017 and May 2018; outcomes were compared with a matched cohort of patients where the temporalis fascia was used. MAIN OUTCOME MEASURES Tympanic membrane closure rate, audiogram threshold, duration of procedure, and donor site scar satisfaction survey. RESULTS Sixty patients were included in this study and were evenly divided into the SMAS and temporalis fascia groups. These cohorts were matched for age, sex, side of lesion, perforation size, and preoperative hearing level. The closure rate was 96.7% (29/30) and 93.3% (28/30) (p = 1.0), mean hearing gain was 8.3 ± 6.4 dB versus 8.2 ± 7.1 dB for air-conduction (p = 0.970) and 7.6 ± 5.1 dB versus 8.2 ± 6.8 dB for air-bone gap (p = 0.716), and mean surgical duration was 137.3 ± 23.0 versus 132.2 ± 27.3 minutes (p = 0.432) for the SMAS and temporalis fascia groups, respectively; there were no statistically significant differences for all the parameters listed. The posttreatment questionnaire survey revealed significantly higher acceptance of the SMAS fascia method. CONCLUSION This preliminary outcome report of SMAS fascia grafting in transcanal endoscopic type I tympanoplasty showed equivalent surgical outcomes and better cosmetic satisfaction compared with the temporalis fascia. The SMAS fascia is a reasonable alternative to conventional techniques for transcanal tympanoplasty.
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Zhang Y, Wang W, Xu K, Hu M, Ma Y, Lin P. Comparison of clinical outcome between endoscopic and postauricular incision microscopic type-1 tympanoplasty. Acta Otolaryngol 2021; 141:29-33. [PMID: 33019832 DOI: 10.1080/00016489.2020.1821091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Microscopic type-1 tympanoplasty (T1T) is a classical method for the treatment of chronic otitis media. However, it has its limitations. The development of otoendoscopy provided a new method for T1T. OBJECTIVE To investigate the difference between endoscopic T1T and microscopic T1T. MATERIAL AND METHODS Seventy-four patients who underwent T1T were evaluated retrospectively. About 52 cases underwent endoscopic T1T, and 22 cases accepted microscopic T1T. Parameters including operative duration, incision size, graft site, duration of postoperative hospitalization, visual analog scale (VAS) score, complications, hearing improvement, and expenses were compared. RESULTS Operative duration of endoscopic T1T (47.0 ± 8.2 min) was shorter than microscopic T1T (58.0 ± 9.3 min) (p < .05). The VAS score under endoscopic T1T (1.5 ± 0.2) was lower than microscopic T1T (5.6 ± 0.4) (p < .05). There was no complication during endoscopic T1T, but damage to the chorda tympani nerve (one case) was noted for microscopic T1T. There was no difference in hearing improvement between endoscopic (15.0 ± 1.5 dB) and microscopic T1T (16.0 ± 1.1 dB). Duration of postoperative hospitalization and expenses were lower for endoscopic T1T. CONCLUSIONS AND SIGNIFICANCE Endoscopic T1T is a minimally invasive surgery with similar graft success rate, comparable hearing improvement, fast recovery, low cost, and high patient satisfaction compared to microscopic T1T.
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Affiliation(s)
- Yonglan Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
- Institute of Otolaryngology of Tianjin, Tianjin, China
- Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China
- Key Clinical Discipline of Tianjin (Otolaryngology), Tianjin, China
- Otolaryngology Clinical Quality Control Centre, Tianjin, China
| | - Wei Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
- Institute of Otolaryngology of Tianjin, Tianjin, China
- Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China
- Key Clinical Discipline of Tianjin (Otolaryngology), Tianjin, China
- Otolaryngology Clinical Quality Control Centre, Tianjin, China
| | - Kaixu Xu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
- Institute of Otolaryngology of Tianjin, Tianjin, China
- Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China
- Key Clinical Discipline of Tianjin (Otolaryngology), Tianjin, China
- Otolaryngology Clinical Quality Control Centre, Tianjin, China
| | - Ming Hu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
- Institute of Otolaryngology of Tianjin, Tianjin, China
- Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China
- Key Clinical Discipline of Tianjin (Otolaryngology), Tianjin, China
- Otolaryngology Clinical Quality Control Centre, Tianjin, China
| | - Yuanxu Ma
- Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
- Institute of Otolaryngology of Tianjin, Tianjin, China
- Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China
- Key Clinical Discipline of Tianjin (Otolaryngology), Tianjin, China
- Otolaryngology Clinical Quality Control Centre, Tianjin, China
| | - Peng Lin
- Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
- Institute of Otolaryngology of Tianjin, Tianjin, China
- Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China
- Key Clinical Discipline of Tianjin (Otolaryngology), Tianjin, China
- Otolaryngology Clinical Quality Control Centre, Tianjin, China
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Abstract
Herein we provide a broad overview of the literature as it applies to endoscopic myringoplasty and type I tympanoplasty. Advantages and disadvantages of the endoscopic approach are reviewed for both the adult and pediatric populations and are compared with conventional microscopic techniques.
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Affiliation(s)
- Zachary G Schwam
- Icahn School of Medicine of Mount Sinai, Department of Otolaryngology-Head and Neck Surgery, 1 Gustave L. Levy Place, Box 1189, New York, NY 10029, USA.
| | - Maura K Cosetti
- Icahn School of Medicine of Mount Sinai, Department of Otolaryngology-Head and Neck Surgery, 1 Gustave L. Levy Place, Box 1189, New York, NY 10029, USA
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Chandrasekhar SS, Ho S, House JW. The Role for Microsurgery of the Ear. Otolaryngol Clin North Am 2020; 54:211-219. [PMID: 33153737 DOI: 10.1016/j.otc.2020.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Microscopic ear surgery (MES) has been used since the 1950s whereas endoscopic ear surgery (EES) was introduced in the mid-1990s. The advantages of MES should not be forgotten as surgeons turn their attention to new technology. These include depth perception, wide angle view, and the ability to operate with 2 hands. EES affords the ability to look around corners but needs a pristine field and is limited to single-handed surgery in a narrow field. Trainees should be taught both, and technique used should reflect the experience and abilities of the surgeon and the nature of the disease in the particular patient.
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Affiliation(s)
- Sujana S Chandrasekhar
- ENT & Allergy Associates, LLP, 18 East 48th Street, 2nd Floor, New York, NY 10017, USA; Zucker School of Medicine; Icahn School of Medicine.
| | - Sandra Ho
- TJH Medical Services, P.C., 89-06 135th Street, Suite 7D, Jamaica, NY 11418, USA
| | - John W House
- House Ear Institute, Geffen-UCLA Medical Center, 2100 West Third Street, Los Angeles, CA 90210, USA
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Han SY, Lee DY, Chung J, Kim YH. Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta-analysis. Laryngoscope 2018; 129:1444-1452. [PMID: 30593662 DOI: 10.1002/lary.27556] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 08/01/2018] [Accepted: 08/13/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Recently, the endoscope has been increasingly introduced for middle-ear surgery. To evaluate the postoperative outcomes of endoscopic ear surgery (EES) in pediatric patients, we did a qualitative analysis with a systematic review and quantitative analysis with meta-analysis of available literature. METHODS Studies reporting the comparative surgical outcomes of EES in pediatric patients were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases from database inception through 2017. The selected articles included clinical studies conducted with at least 30 subjects and at least one postoperative parameter, including residual or recurrent cholesteatoma and graft success in tympanoplasty. Two investigators independently reviewed all studies and extracted the data using a standardized form. A meta-analysis was performed using a random-effects model and qualitative review was performed on the smaller studies. RESULTS Ten studies were identified as appropriate for quantitative meta-analysis and 19 studies for qualitative analysis. In the meta-analysis, residual or recurrence rate of cholesteatoma was significantly lower in the EES group than in the microscopic ear surgery (MES) group (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.38-0.84, P = .005). The graft success rate of tympanoplasty was not statistically different between EES and MES groups (OR: 0.72, 95% CI: 0.41-1.26, P = .249). In the qualitative analysis, most of the studies reported similar audiological outcomes after tympanoplasty and success rate of cholesteatoma removal between the two groups. CONCLUSIONS It appears that EES reduces the risk of residual cholesteatoma in children and that the success of perforation closure is equivalent to MES. Laryngoscope, 129:1444-1452, 2019.
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Affiliation(s)
- Sang-Yoon Han
- the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Doh Young Lee
- the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Juyong Chung
- the Department of Otolaryngology-Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
| | - Young Ho Kim
- the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Comparison of endoscopic transcanal myringoplasty and endoscopic type I tympanoplasty in repairing medium-sized tympanic perforations. Auris Nasus Larynx 2017; 44:672-677. [DOI: 10.1016/j.anl.2016.12.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/29/2016] [Accepted: 12/30/2016] [Indexed: 11/28/2022]
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Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Short-term Subjective and Objective Outcomes of Patients Receiving Endoscopic Transcanal Myringoplasty for Repairing Tympanic Perforations. Otolaryngol Head Neck Surg 2017; 158:337-342. [DOI: 10.1177/0194599817735501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Endoscopic transcanal myringoplasty (ETM) has been an emerging technique for repairing tympanic perforations since the late 1990s. Objective outcomes (ie, graft success rates and hearing results) of patients who received ETM are well documented; however, subjective outcomes of these patients have rarely been reported. Hence, this study evaluated subjective and objective outcomes of patients who received ETM for repairing tympanic perforations. Study Design Prospective study. Setting Tertiary care university hospital. Patients and Methods Patients who underwent ETM for perforations of the tympanic membrane were included. We evaluated subjective variables of patients receiving ETM as the primary outcome and objective variables as the secondary outcome. Results In total, 91 ears that underwent ETM were included. The mean pain scale score was 0.1 (range, 0-2) on postoperative day 3. The mean duration of pain medication was 2.0 (range, 0-3) days. The mean number of days required to resume routine activities was 1.0 (range, 1-2) days. The overall graft success was determined postoperatively at 3 months in 80 of 91 ears (87.9%). Closure of the air-bone gap to within 20 dB was achieved in 79 (86.8%) ears. Conclusion In this study, patients who received ETM had mild postoperative pain and resumed routine activities early. These patients also exhibited favorable graft success rates and hearing results at 3 months postoperatively. On the basis of our results, we conclude that patients who receive ETM for the repair of tympanic perforations have favorable short-term subjective and objective outcomes.
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Affiliation(s)
- Chih-Chieh Tseng
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, PoJen General Hospital, Taipei, Taiwan
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Tang Lai
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
| | - Chia-Che Wu
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Po Yuan
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
| | - Yi-Fang Ding
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
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Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Endoscopic transcanal myringoplasty for tympanic perforations: An outpatient minimally invasive procedure. Auris Nasus Larynx 2017; 45:433-439. [PMID: 28739189 DOI: 10.1016/j.anl.2017.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/09/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty). METHODS We retrospectively reviewed the medical records of patients who underwent endoscopic transcanal myringoplasty for perforations of the tympanic membrane. The main outcome was the overall rate of graft success of endoscopic transcanal myringoplasty. RESULTS A total of 181 patients were included in the analysis. The overall graft success was determined in 163 of 181 patients (92.8%). The mean preoperative and postoperative air-bone gaps were 19.3dB and 7.8dB, respectively, revealing a significant improvement of 11.5dB (Cohen's d, 1.27; 95% CI, 1.03-1.50; P<0.05; paired t test) in the air-bone gap. The rate of graft success with partial visualization of the perforation margin was comparable to that with complete visualization of the perforation margin. Larger sizes of perforations were significantly associated with lower rates of graft success (P<0.01). CONCLUSION Our study revealed that the rate of graft success and hearing results of endoscopic transcanal myringoplasty and microscopic myringoplasty are comparable for repairing perforations of the tympanic membrane. Visualization of the perforation margin by otoscopy did not affect the rate of graft success. However, endoscopic transcanal myringoplasty is less invasive because this technique does not require postauricular incision, canalplasty, and general anesthesia.
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Affiliation(s)
- Chih-Chieh Tseng
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taiwan; Department of Otolaryngology, PoJen General Hospital, Taipei, Taiwan; Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taiwan.
| | - Ming-Tang Lai
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taiwan
| | - Chia-Che Wu
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taiwan; Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taiwan
| | - Sheng-Po Yuan
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taiwan
| | - Yi-Fang Ding
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taiwan
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Lou Z. In reference to Pediatric endoscopic ear surgery in clinical practice: Lessons learned and early outcomes. Laryngoscope 2017; 127:E417. [PMID: 28699198 DOI: 10.1002/lary.26758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/24/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Zhengcai Lou
- Department of Otorhinolaryngology, The Affiliated YiWu Hospital of Wenzhou Medical University, Zhejiang, China
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Doğan S, Bayraktar C. Reply to the letter to the editor concerning "Endoscopic tympanoplasty: learning curve for a surgeon already trained in microscopic tympanoplasty". Eur Arch Otorhinolaryngol 2017; 274:4061-4062. [PMID: 28560555 DOI: 10.1007/s00405-017-4613-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Sedat Doğan
- Adıyaman University Faculty of Medicine, E.N.T. Clinic, Adıyaman, Turkey.
| | - Cem Bayraktar
- Adıyaman University Faculty of Medicine, E.N.T. Clinic, Adıyaman, Turkey
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Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: A systematic review and meta-analysis. Laryngoscope 2016; 127:1890-1896. [PMID: 27861950 DOI: 10.1002/lary.26379] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Microscopic tympanoplasty has been the standard surgery for repairing perforated tympanic membranes since the 1950s, but endoscopic tympanoplasty has been increasingly practiced since the late 1990s. In this study, we compared the efficacies of endoscopic and microscopic tympanoplasty. DATA SOURCES PubMed, Embase, MEDLINE, and the Clinical Trial Register. REVIEW METHODS We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We included clinical studies that compared the efficacies of endoscopic and microscopic tympanoplasty. We assessed the risk of bias and calculated the pooled relative risk (RR) estimates with 95% confidence interval (CI). RESULTS We identified four studies (involving 266 patients in total) that met the inclusion criteria. The pooled tympanic membrane closure rates and hearing results of endoscopic and microscopic tympanoplasty were comparable (85.1% vs. 86.4%, respectively; RR: 0.98; 95% CI: 0.85 to 1.11; I2 = 0) (mean difference of improvements of air-bone gaps: -2.73; 95% CI: -6.73 to 1.28; I2 = 80%). The pooled canalplasty rate of endoscopic tympanoplasty was significantly lower than that of microscopic tympanoplasty. Patients receiving endoscopic tympanoplasty had a more desirable cosmetic result than did those receiving microscopic tympanoplasty. CONCLUSIONS Our up-to-date review evidences the comparable tympanic membrane closure rates and hearing results for endoscopic and microscopic tympanoplasty. Patients receiving endoscopic tympanoplasty have a lower canalplasty rate and more desirable cosmetic result than do those receiving microscopic tympanoplasty. Laryngoscope, 127:1890-1896, 2017.
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Affiliation(s)
- Chih-Chieh Tseng
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.,Department of Otolaryngology, PoJen General Hospital, Taipei, Taiwan
| | - Ming-Tang Lai
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
| | - Chia-Che Wu
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.,Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Po Yuan
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
| | - Yi-Fang Ding
- Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
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Niazi SA, Hassan ZU, Atif K, Ullah S. Comparison of permeatal medial placement of graft without raising the tympano-meatal flaps to conventional methods of myringoplasty: An experience at tertiary care hospital in Pakistan. Pak J Med Sci 2016; 32:927-30. [PMID: 27648041 PMCID: PMC5017104 DOI: 10.12669/pjms.324.9497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: To compare the results of permeatal approach without raising the tympano-meatal flap to end-aural or post-aural approach in myringoplasty. Methods: This Quasi-experimental study was carried out in CMH (Combined Military Hospital) Peshawar, from August 2006 to July 2013. Three hundred fifty patients of chronic suppurative otitis media (CSOM) with dry central; small, medium and large perforations were selected. They were divided into two groups depending upon the type of approach. In Group-A (n-200); permeatal approach without raising tympano-meatal flap was used; while in Group-B (n-150) end-aural or post-aural approach was used. Subjects were followed up for two years; graft take was checked regularly by examinations of ear under microscope. Data was collected on structured Performa and analysed by SPSS-17. Results: Male and female were 74% and 26% respectively; Age ranged from 15 to 46 Years. There was no significant difference in the graft success at the end of two years in Group-A(80%) and Group-B(85%) (p-0.261). Type of approach had a significant impact on duration of surgery(p<0.001) and post-operative recovery time(p<0.001). Conclusion: The permeatal approach and end-aural/post-aural approach had almost equal graft success rates, but former is more useful as it causes lesser morbidity, decreased post-operative hospital stay and reduced operative time. It is under-utilized and should be employed more frequently.
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Affiliation(s)
- Saleem Asif Niazi
- Dr. Saleem Asif Niazi, MBBS, MCPS, FCPS Department of ENT, Combined Military Hospital, Peshawar, Pakistan
| | - Zaheer Ul Hassan
- Dr. Zaheer Ul Hassan, MBBS, FCPS Department of ENT, Combined Military Hospital, Peshawar, Pakistan
| | - Khaula Atif
- Dr. Khaula Atif, MBBS, MCPS(Family-Medicine), DPH, DMA. Department of General Administration, Combined Military Hospital, Peshawar, Pakistan
| | - Saeed Ullah
- Dr. Saeed Ullah, MBBS, FCPS Department of ENT, Combined Military Hospital, Quetta, Baluchistan, Pakistan
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