Research of Ear Endoscopic Type I Tympanoplasty——Single-institution Experiences in China

Purpose: To assess outcomes of one-handed ear endoscopic Type I Tympanoplasty and summarize the experience. Methods: This study retrospectively analyzed 34 cases (23 females and 11 males) of one-handed ear Endoscopic Type I Tympanoplasty. Result: The mean values of air conduction threshold before and after surgery were 48.22+18.36dB HL and 34.34+19.83dB HL, respectively. The mean values of the air-bone gap before and after surgery were 23.60+12.18 dB HL and 11.05+6.62 dB HL, respectively. The results showed statistically significant differences in hearing improvement(P<0.05). Among 34 ears, 30 ears had effective hearing improvement. No vertigo, intracranial infection, suppuration, and any other postoperative complications occurred. Although 1 ear occurred tympanic membrane perforation again, all ears achieved dry. Conclusion: Ear endoscopic Type I Tympanoplasty with fewer complications and shorter surgery time were suitable for the chronic suppurative otitis media. Healing of the tympanic membrane and recovery of hearing level was ensured. However, the experience is still insufficient in China, so a large number of clinical workers need to exchange experience to promote the development of ear minimally invasive surgery.

Comparison of Tympanic Membrane Perforation With and Without Calcification of Anterior Mallear Ligament Under Transcanal Endoscopic Type I Tympanoplasty

Objectives: Chronic suppurative otitis media (CSOM) induced tympanic membrane perforation (TMP) can be accompanied by anterior mallear ligament (AML) calcification. So far, comparative evaluations of TMP with and without AML calcification have rarely been reported. The aim of the current study is to compare the hearing outcomes of TMP with and without calcification of AML under transcanal endoscopic type I tympanoplasty. Methods: Records of 67 patients diagnosed with CSOM and receiving transcanal endoscopic type I tympanoplasty were divided into the AML calcification group (Cal group, n = 31) and the non-AML calcification group (non-Cal group, n = 36). The 31 patients in the Cal group were divided into subgroup A and B according to the severity of calcification. The operation time, closure rate, and pre- and postoperative audiometric results were retrospectively collected and analyzed. Results: Preoperatively, the Cal group had higher mean air–bone gap (ABG; P = .022), and ABGs at 250 Hz ( P = .017) and 500 Hz ( P = .008) compared with the non-Cal groups. The Cal group showed higher improvements of ABGs at 250 Hz ( P = .039) and 500 Hz ( P = .021) compared with the non-Cal groups postoperatively. Conclusions: The TMP with AML calcification leads to higher ABGs at low frequencies. The hearing outcomes are similar for TMP both with and without AML calcification after surgery. Our results suggest that transcanal endoscopic type I tympanoplasty is an appropriate surgical method for TMP with AML calcification, if the lesion can be detected and completely eliminated.