Clin Exp Otorhinolaryngol.  2015 Sep;8(3):224-229. 10.3342/ceo.2015.8.3.224.

Endoscopic "Push-Trough" Technique Cartilage Myringoplasty in Anterior Tympanic Membrane Perforations

• Celik H
• Samim E
• Oztuna D

• KMID: 2117516
• DOI: http://doi.org/10.3342/ceo.2015.8.3.224

Abstract

OBJECTIVES
To evaluate endoscopic push-through technique cartilage myringoplasty results.
METHODS
This prospective study was performed on patients with anterior tympanic membrane perforations and endoscopic push-through technique cartilage myringoplasty was performed between 2011 and 2013. The patients who did not have any cholesteatoma or otorrhea in the previous 3 months, and had an air bone gap < or =25 dB in their preoperative audiograms were included in the study. They were followed up with endoscopic examination and audiograms at 2nd, 6th, 12th, and 24th postoperative months. Pure tone averages were calculated at 0.5, 1, 2, and 4 kHz frequencies.
RESULTS
Of 32 patients, 19 were females and 13 were males. The mean age was 40.3 years (range, 16 to 62 years), and the mean follow-up period was 12.4 months (range, 6 to 24 months). Graft success rate was 87.5% in this study. Preoperative mean air conduction hearing threshold was 25.9 dB, and the mean air-bone gap was 11.9 dB while these values improved to 19.5 dB and 5.3 dB respectively in the postoperative period. The mean hearing gain was 6.4 dB. The analysis of preoperative and postoperative mean air conduction thresholds and air bone gap values of the patients revealed statistically significant differences.
CONCLUSION
Underlay cartilage myringoplasty with endoscopic push-through technique in anterior quadrant tympanic membrane perforations is an effective, minimally invasive and feasible method.

Keyword

Endoscopy; Cartilage; Myringoplasty; Tympanic Membrane

MeSH Terms

Cartilage*
Cholesteatoma
Endoscopy
Female
Follow-Up Studies
Hearing
Humans
Male
Myringoplasty*
Postoperative Period
Prospective Studies
Transplants
Tympanic Membrane*

Figure

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  Fig. 1 Desepitelizaiton of the perforation edges.

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  Fig. 2 Cartilage graft placed underlay through the perforation with push-through technique.

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  Fig. 3 Placement of the graft. (A) Pushing the graft through the perforation, and rotating it; (B) placing the graft to close the perforation.

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  Fig. 4 Postoperative endoscopic appearances of the patients. (A) The appearance of vascularization on the cartilage graft at second postoperative month, left ear; (B) The appearance of the cartilage after one year postoperatively, right ear; (C) The appearance of cartilage anterior to malleus manibrium, and the vascular structures feeding it at postoperative 6th month, right ear; (D) The appearance of the pearl cholesteatoma (white arrow) placed at inferior-posterior end of the intact cartilage graft at postoperative 6th month, right ear.

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