Endoscopic 3-S Technique Tympanoplasty: Taking the Convention a Step Ahead
Article Sidebar
Main Article Content
Abstract
Introduction
Endoscopic Surgery has immense potential for middle ear surgery and is currently favoured by many surgeons. The 3 (vascular) Strips/ 3 Flap Tympanoplasty with operating microscope is popular but Endoscopic 3-Flap Tympanoplasty remains less explored. Hence this study was conducted to compare advantages and disadvantages of Endoscopic and Microscopic 3-Flap Tympanoplasty.
Materials and Methods
Forty two patients with large/subtotal perforation of tympanic membrane were divided into two equal groups (Group A & B). Endoscope was used in Group A, whereas, operating microscope in Group B. Temporalis fascia was the graft material in all patients. Patients were followed up for six months. Pre and post-operative audiograms, post-operative pain, graft uptake, time taken for surgery and intra-operative visualization convenience were compared.
Results
Mean Air-Bone Gap closure at the end of six months was 9.23 dB (SD-0.88 dB) in the endoscope group and 8.95 dB (SD-0.66 dB) in microscope group whereas the graft uptake rate was 95.2% and 90.2% respectively. Post-operative pain, cosmesis, ease of doing surgery and time taken for surgery were better in ‘Endoscope’ as compared to ‘Microscope’ group.
Conclusion
The three flaps produce adequate exposure in very large or subtotal perforations, very thin anterior rim or with anterior bony overhang. Results in terms of mean hearing gain and graft uptake were comparable. In terms of morbidity (post-op pain), recovery (return to routine activity), mean duration of surgery and cosmesis, endoscopic surgery produced better outcome.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Harugop AS, Mudhol RS, Godhi RA. A comparative study of endoscope assisted myringoplasty and microscope assisted myringoplasty. Indian J Otolaryngol Head Neck Surg. 2008; 60:298-302
Glasscock ME, Shambaugh GE. Tympanoplasty. In: Glasscock and Shambaugh, Eds. Surgery of the Ear, 5th ed. People’s Medical Publishing House, Connecticut, p 350-70
Tarabichi M. Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol. 1999; 108: p 39-46
Roychaudhuri BK. 3-Flap Tympanoplasty- A simple and sure success technique. Indian J Otolaryngol Head Neck Surg. 2004; 56(3):196-200
El-Guindy A. Endoscopic transcanal myringoplasty. J Laryngol Otol. 1992; 106:493-5
Raj A, Meher R. Endoscopic transcanal myringoplasty-a study. Indian J Otolaryngol Head Neck Surg. 2001; 53(1):47-9
Jyothi AC, Shrikrishna BH, Kulkarni NH, Kumar A. Endoscopic Myringoplasty Versus Microscopic Myringoplasty in Tubotympanic CSOM: A Comparative Study of 120 Cases. Indian J Otolaryngol Head Neck Surg. 2017; 69(3):357-62
Patil RN. Endoscopic tympanoplasty—definitely advantageous (preliminary reports). Asian J Ear Nose Throat 2003; 25:9-13
Mer SB, Derbyshire AJ, Brushenko A, Pontarelli DA. (1967) Fibreoptic endotoscopes for examining the middle ear. Arch Otolaryngol. 1967; 85:387-93
Patel J, Aiyer RG, Gajjar Y, Gupta R, Raval J, Suthar PP. (2015) Endoscopic tympanoplasty vs microscopic tympanoplasty in tubotympanic CSOM: a comparative study of 44 cases. Int J Res Med Sci. 2015; 3(8):1953-7.