Tympanoscope-assisted myringoplasty

Thirty ears of 29 patients with different sized perforation of the tympanic membrane were operated on with the aid of rigid otoendoscopes. The techniq ue has a significant novel feature: endoscopy of the tympanic cavity throug h a perforation with small tympanoscopes 1.7 mm in diameter with a 0 degree s, 30 degrees and 90 degrees angle of view. It was possible to visualize an d remove epithelial migration into the tympanic cavity and to the medial su rface of the tympanic membrane under tympanoscopic inspection. A skin incis ion above the hairline was needed to harvest a piece of temporal fascia to seal the perforation. The overall success rate for perforation closure was 80%. The postoperative air-bone gap was less than 10 dB in 90% of the ears. It was concluded that tympanoscope-assisted myringoplasty is a reliable an d simple procedure with the benefit of minimal trauma in healthy tissue and that it is a feasible approach for day-case surgery with an ordinary succe ss rate of tympanic membrane closure and hearing results. Copyright (C) 200 1 S. Karger AG, Basel.