Hybrid Retroauricular Approach Without Ear Canal Skin Incision

The majority of tympanoplasty procedures have been performed using the retroauricular approach to improve visualisation of the anterior tympanic membrane. The classic retroauricular approach requires elevation of the Körner flap and tympano-meatal flap through the ear canal skin incision. This step can lead to the exposure of the bones in the ear canal, resulting in delayed wound healing and pain, especially in elderly or immunocompromised patients. Endoscopic ear surgery is a minimally invasive procedure that offers a wider field of view, but has the disadvantage of being a one-handed operation and cannot avoid skin incisions in the ear canal for tympanoplasty. Here we present a hybrid retroauricular approach without skin incision of the ear canal, using both microscope and endoscope. This method provides very fast wound healing and significantly less pain.