Endoscopic Transcanal Push-Trough Myringoplasty for Different Types of Tympanic Membrane Perforations

Objective: This study aims to explore the feasibility of endoscopic transcanal push-trough myringoplasty (ETPM) for all types of tympanic membrane perforations (TMPs), and compare the outcomes with those of endoscopic type 1 tympanoplasty (ETT) with meatal flap elevation. Study Design: A prospective, controlled study. Methods: In the present study, inpatients with TMPs were divided into two groups according to the manner of tympanic membrane repair: one group received ETPM without raising the meatal flap, and the other received ETT. The operation duration, postoperative healing rate, visual analogue scale (VAS) of pain, and complication rates were compared between these two groups. Results: Regardless of the size and location of the perforation, and its relationship with the malleus manubrium, myringoplasty can be completed using the ETPM method. The operation duration for different types of TMPs was shorter in the ETPM group than in the ETT group, and the difference was statistically significant (p<0.05). However, there was no statistical difference in the short-term healing rate (p>0.05) and pain VAS score (p>0.05) between these two groups. Furthermore, no intraoperative or postoperative complications occurred in both groups. Conclusion: ETPM without raising the meatal flap can be applied for all types of TMPs, regardless of how large the perforation is, or where it is located. This can shorten the operation duration, and has a high healing rate comparable to ETT and mild postoperative pain. Mastering some essential surgical skills under the endoscope would be helpful to ensure the success of the surgery.