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Endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal to repair marginal perforations.

ABSTRACT: OBJECTIVE:To evaluate the graft success rate and postoperative hearing gain for marginal perforations using endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal (EAC). STUDY DESIGN:Prospective case series. MATERIALS AND METHODS:We performed a prospective study in 41 patients with marginal perforations who underwent endoscopic cartilage myringoplasty with the removal of a small rim of EAC. Patients were followed up for 6?months. RESULTS:Of the 41 patients with unilateral marginal perforation included in this study, the graft success rate was 100% (41/41). The mean ABG improved from 11.31?±?9.71?dB preoperatively to 7.31?±?2.32?dB postoperatively for small-and medium-sized perforations (P?=?0.13); the mean ABG improved from 21.46?±?8.39?dB preoperatively to 9.84?±?2.41?dB postoperatively for large perforations (P?

SUBMITTER: Lou ZC

PROVIDER: S-EPMC7060568 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal to repair marginal perforations.

Lou Zheng-Cai ZC

Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 20200306 1

<h4>Objective</h4>To evaluate the graft success rate and postoperative hearing gain for marginal perforations using endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal (EAC).<h4>Study design</h4>Prospective case series.<h4>Materials and methods</h4>We performed a prospective study in 41 patients with marginal perforations who underwent endoscopic cartilage myringoplasty with the removal of a small rim of EAC. Patients were followed up for 6 months.<h ...[more]

PMID: 32143701

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Project description:To compare the results of myringoplasty by using operating microscope (postaural) with that of myringoplasty by using endoscope (permeatal). Our study was conducted in Department of ENT of in Chirayu Medical College and Hospital. Total 60 patients of age group 18-60 were taken for study having chronic otitis media or trauma with central perforation. Patients were randomly selected microscopic or endoscopic myringoplasty. 30 patients for Microscopic Myringoplasty and 30 patients for endoscopic Myringoplasty were selected. Out of total 60 patients 35 were females and the 25 were males, 27 were in the age group 15-30 and 23 were in age group 31-45 and only 10 in the age group of 46-60. 18-30 age group cohort was predominant. The average time taken for endoscopic myringoplasty was 65.5?±?3.45 min and for microscopic myringoplasty 85.7?±?3.42 min. 26 were having Large central perforation (LCP), of which 13 underwent microscopic and 13 underwent endoscopic myringoplasty. The graft was taken up in situ in 22 patients while 4 patients had small residual central perforation. Out of these four residual perforations 3 were done by endoscopy and 1 by microscopy. 19 (of 60) were having Medium size central perforation (MCP), 10 were operated with endoscope and 9 with microscope. 15 (60) were having Small central perforation (SCP), 7 done with endoscope and 8 with microscope. In all patient graft take up was well. Large central perforation present in maximum patient and had least graft uptake as compared to MCP and SCP. Out of the 30 these endoscopic myringoplasty 27 patients had good graft uptake and 3 had small central residual perforation after 3 months. Out of the 30 microscopic myringoplasty 29 patients had good graft uptake and 1 patient had small central residual perforation after 3 months. In our study pre operative and post operative Air Bone Gaps (ABGs) were 22.05?±?2.04 and 9.05?±?1.36 db respectively in endoscopic myringoplasty and 21.81?±?1.85 and 8.55?±?1.44 db respectively in microscopic myringoplasty. Microscopic myringoplasty has greater success rate in larger perforations that is LCP and MCP and equal result in SCP. Advantage of microscope is depth perception and both hands are free for procedure which is limitation of endoscopic myringoplasty (need to use endoscope holder). Advantage of endoscopic permeatal myringoplasty is superior visualization, least tissue trauma and better cosmetic outcome, almost equal graft uptake and hearing outcome with less operative time. Endoscope system is portable, so convenient for surgeon where microscope is not available. Also endoscope is a less costly armamentarium. Our study shows better result in myringoplasty can be achieved if both methods of surgery are used in combination.

Dataset Information

Endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal to repair marginal perforations.

Publications

Endoscopic cartilage myringoplasty with the removal of a small rim of the external auditory canal to repair marginal perforations.

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