Outcomes Following Transcanal Endoscopic Lateral Graft Tympanoplasty

Francis Creighton, Elliot Kozin, Anni Rong, Michael Cohen, Daniel Lee

Research output: Contribution to journalArticle

Abstract

Outcome Objectives: Demonstrate feasibility of performing endoscopic transcanal lateral graft tympanoplasty.Compare audiometric and clinical outcomes of transcanal endoscopic lateral graft with previously reported outcomes of microscopic post-auricular lateral graft tympanoplasty. Methods: A retrospective review of sequential pediatric and adult endoscopic transcanal lateral graft tympanoplasties (type I) performed between May 2014 and August 2015 at a single institution by two experienced otologists. Rate of perforation closure and audiometric outcomes (pure-tone average [PTA] and word recognition scores [WRS]) were obtained and compared with previous published outcomes of post-auricular microscopic lateral grafts. Results: Twenty patients, five right and 15 left ears, met criteria. Ninety percent of patients had successful closure of their perforation. One patient had a residual central perforation; active acute otitis media was noted intraoperatively in this case. One patient had graft lateralization. Mean follow up was 10.5 months (standard deviation [SD] = 141 d). Mean operative time was 160 (SD = 26.1) minutes. Mean improvement in PTA was 18 dB (SD = 10.3). Two patients had worsening of audiometric outcomes with <15 dB decreases in PTA and unchanged WRS; all other patients showed improvement or no change in audiometric outcomes. These results are similar to previously published outcomes for post-auricular microscopic approaches. Conclusion: Transcanal endoscopic lateral graft tympanoplasty is a novel technique for closure of anterior and subtotal perforations that avoids a postauricular incision. Outcomes in this cohort were similar to historical results for post-auricular microscopic approaches. Prospective studies with larger cohorts will be crucial to understanding the advantages and limitations of this new surgical approach.

Original languageEnglish (US)
JournalOtology and Neurotology
DOIs
StateAccepted/In press - Jan 1 2019

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Keywords

  • Endoscopic ear surgery
  • Lateral graft
  • Tympanic membrane perforations
  • Tympanoplasty

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

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