Endoscopic transcanal myringoplasty
The role of the rigid endoscope has been evaluated in the management of 36 cases with dry central perforation of the tympanic membrane. The graft take rate was 91.7 per cent and the air-bone gap was closed to less than 10 dB in 83.3 per cent. The use of the rigid endoscope in the management of dry central perforation of the drum represented a significant advance in middle ear surgery. It is used, in correlation with manometry, to evaluate the tubal function before ear surgery and to treat hidden causes of tubal obstruction. It replaces the operating microscope in observation and surgery of the tympanic membrane perforation. It overcomes anatomical variations that hamper access to the entire tympanic membrane during ear surgery. It provides an extremely sharp image with high resolution.
Available from: Marco Berlucchi
- "Recently, several authors described the advantages of an endoscopic approach over the operating microscope    . However, to date few papers have been published on the results of endocanal endoscopic MP (without tympanomeatal flap)       or transcanal endoscopic MP (with tympanomeatal flap)    . Moreover, most endoscopic MPs in these reports were performed on adults     and only recently a paper have been published on tanscanal endoscopic MP in children . "
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ABSTRACT: To evaluate the results of a newly introduced technique to our Department of endoscopic assisted transcanal myringoplasty applied in tympanic membrane perforation in children of any age and compare them to that of the previously standard microscopic assisted myringoplasty technique.
A retrospective study of myringoplasties performed between January 2005 and June 2014 in children suffering from chronic otitis media with perforation. In microscope-assisted cases, a transcanal approach was applied when the anterior tympanic annulus was completely visible through the ear speculum, and a postauricular approach was used in all other cases. A transcanal approach was used in all endoscopic-assisted cases.
Between January 2005 and December 2010 and January 2011 and June 2014, 23 and 22 myringoplasties were performed by means of an operative microscope and an endoscope, respectively. Patient age varied from 5 to 16 years. Median duration of microscopic and endoscopic approaches was 90min and 80min (P=0.3), respectively. Hospital stay after surgery was significantly longer in the microscope group than the endoscope group (P<0.001). The intact graft success rate was 82.6% in microscopic and 90.9% in endoscopic approaches. Median postoperative air-bone gap of microscopic and endoscopic approaches was 6.2dB and 6.6dB, respectively (P=0.9). Neither intra- nor postoperative complications were observed.
Endoscopic transcanal myringoplasty is an alternative surgical approach to traditional technique. This surgery is more conservative than microscopic approach and can be performed in all pediatric cases independently from age. Moreover, it offers comparable anatomical and functional results to the traditional surgery, and grants better comfort for the child.
Copyright © 2015. Published by Elsevier Ireland Ltd.
Available from: arquivosdeorl.org.br
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ABSTRACT: Our experience with myringoplasty by the transtympanic "push through' technique in paediatric patients is described. We have used this method in 40 children utilizing autologous temporalis fascia as the graft material. The procedures were all performed as day cases under general anaesthesia. The overall success rate for perforation closure was 77.5% at 6 months which is comparable to conventional methods. We conclude that the "push-through' technique is a safe, simple, reliable and cost-effective procedure that can be performed as a day case in paediatric patients. It avoids the necessity for pressure bandaging or formal ear packing. To our knowledge this is the first paper evaluating this technique in children.
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