{"title":"Endoscopic annular chondroperichondrial tympanoplasty, technical description.","authors":"M Ihsan Gülmez, Şemsettin Okuyucu","doi":"10.1007/s00405-025-09238-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Tympanoplasty is a surgical procedure performed to cure middle ear infections and restore normal middle ear function. It is one of the most common procedures in otological surgery. Since Wullstein described tympanoplasty, the microscope has been a widely used surgical tool in otological surgery. Transcanal endoscopic ear surgery (TEES) has come to the forefront as an alternative option due to the various limitations of microscopic surgery and the development of otological surgical techniques. When reviewing the types and tecniques of grafts used in tympanoplasty in the current literature, it is clear that the ideal graft material and tecnique to meet all needs has not yet been found. The objective of this study is to describe a novel graft technique, a modification of the cartilage-perichondrium graft obtained from tragal cartilage, which is believed to represent an optimal solution for the desired graft technique at the highest level.</p><p><strong>Material&method: </strong>The study included 40 patients who underwent endoscopic annular chondroperichondrial tympanoplasty at Hatay Mustafa Kemal University Hospital between 2015 and 2022. All patients underwent clinical otological examination and pure tone audiometry before and after surgery. Hearing results were expressed as pure tone mean air-bone gap (ABG) at 4 frequencies (500,1000,2000,4000 Hz). For all operations, the primary surgeon was the second author. Patients with inadequate follow-up, revision surgery, inflammatory middle ear mucosa, perforation etiology other than chronic otitis media were not included in the study.</p><p><strong>Results: </strong>No complications were observed in the patients included in the study. Accordingly, the graft was intact at the end of the 6th month in 38 of the 40 patients operated on. The graft success rate was 95%. The mean preoperative PTA-ABG was 22.1. The mean post-operative PTA-ABG was 5.7. Mean closed PTA-ABG was 16.4.</p><p><strong>Conclusion: </strong>In parallel with the development of otological surgical technologies, endoscopy is becoming increasingly important in tympanoplasty. We believe that our technique, endoscopic annular chondroperichondrial tympanoplasty, will be an important step in the search for the ideal grafting technique.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3465-3471"},"PeriodicalIF":2.2000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321655/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Archives of Oto-Rhino-Laryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00405-025-09238-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/25 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Tympanoplasty is a surgical procedure performed to cure middle ear infections and restore normal middle ear function. It is one of the most common procedures in otological surgery. Since Wullstein described tympanoplasty, the microscope has been a widely used surgical tool in otological surgery. Transcanal endoscopic ear surgery (TEES) has come to the forefront as an alternative option due to the various limitations of microscopic surgery and the development of otological surgical techniques. When reviewing the types and tecniques of grafts used in tympanoplasty in the current literature, it is clear that the ideal graft material and tecnique to meet all needs has not yet been found. The objective of this study is to describe a novel graft technique, a modification of the cartilage-perichondrium graft obtained from tragal cartilage, which is believed to represent an optimal solution for the desired graft technique at the highest level.
Material&method: The study included 40 patients who underwent endoscopic annular chondroperichondrial tympanoplasty at Hatay Mustafa Kemal University Hospital between 2015 and 2022. All patients underwent clinical otological examination and pure tone audiometry before and after surgery. Hearing results were expressed as pure tone mean air-bone gap (ABG) at 4 frequencies (500,1000,2000,4000 Hz). For all operations, the primary surgeon was the second author. Patients with inadequate follow-up, revision surgery, inflammatory middle ear mucosa, perforation etiology other than chronic otitis media were not included in the study.
Results: No complications were observed in the patients included in the study. Accordingly, the graft was intact at the end of the 6th month in 38 of the 40 patients operated on. The graft success rate was 95%. The mean preoperative PTA-ABG was 22.1. The mean post-operative PTA-ABG was 5.7. Mean closed PTA-ABG was 16.4.
Conclusion: In parallel with the development of otological surgical technologies, endoscopy is becoming increasingly important in tympanoplasty. We believe that our technique, endoscopic annular chondroperichondrial tympanoplasty, will be an important step in the search for the ideal grafting technique.
目的:鼓室成形术是一种治疗中耳感染和恢复正常中耳功能的外科手术。这是耳科手术中最常见的程序之一。自wollstein描述鼓室成形术以来,显微镜已成为耳科手术中广泛使用的手术工具。由于显微手术的各种局限性和耳科外科技术的发展,经鼻内窥镜耳手术(TEES)作为一种替代选择已经走到了前沿。在回顾目前文献中用于鼓室成形术的移植物类型和技术时,显然尚未找到满足所有需求的理想移植物材料和技术。本研究的目的是描述一种新的移植技术,一种从耳屏软骨中获得的软骨-软骨膜移植的改良,被认为是最高水平所需移植技术的最佳解决方案。材料与方法:该研究纳入了2015年至2022年在Hatay Mustafa Kemal大学医院接受内窥镜环状软骨鼓室成形术的40例患者。所有患者术前、术后均行临床耳科检查及纯音听力学检查。听力结果以500、1000、2000、4000 Hz 4个频率下的纯音平均气骨间隙(ABG)表示。对于所有的手术,主外科医生都是第二作者。随访不充分、翻修手术、炎症性中耳黏膜、非慢性中耳炎病因穿孔的患者未纳入研究。结果:本组患者无并发症发生。因此,40例手术患者中有38例在6个月结束时移植物是完整的。移植成功率为95%。术前平均PTA-ABG为22.1。术后平均PTA-ABG为5.7。平均闭合PTA-ABG为16.4。结论:随着耳科外科技术的发展,内窥镜在鼓室成形术中的作用越来越重要。我们相信我们的技术,内窥镜环状软骨鼓室成形术,将是寻找理想移植技术的重要一步。
期刊介绍:
Official Journal of
European Union of Medical Specialists – ORL Section and Board
Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery
"European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level.
European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.