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 technique has a significant novel feature: endoscopy of the tympanic cavity through a perforation with small tympanoscopes 1.7 mm in diameter with a 0 degrees, 30 degrees and 90 degrees angle of view. It was possible to visualize and remove epithelial migration into the tympanic cavity and to the medial surface of the tympanic membrane under tympanoscopic inspection. A skin incision 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 and 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 success rate of tympanic membrane closure and hearing results. Copyright (C) 2001 S. Karger AG, Basel.