Endoscopic tympanoplasty using Tutoplast versus conventional microscopic tympanoplasty

Abstract

Abstract Background Temporalis fascia and perichondrium are still the most successful graft materials for primary microscopic repair of tympanic membrane perforations worldwide with 80% to 90% success rate. However, minimally invasive surgery is becoming standard in many fields and the endoscope has been largely incorporated in ear surgery over the past 10 years. This study aimed to evaluate the success rate of endoscopic transcanal closure of tympanic membrane perforation using Tutoplast® compared with the conventional post auricular approach using homologous temporalis fascia graft. Results Our study was conducted on 50 patients, were equally divided into 2 groups. Group A patients have been operated endoscopic transcanal using the Tutoplast as a graft material. Group B patients have been operated using a temporalis fascia graft through a post-auricular approach. The graft take rate, the pre- and post-operative pure tone audiogram, and operative time were compared in both the groups. The graft uptake rate was 100% in both groups. The mean of ABG showed significant improvement in both groups. In group A, the mean of ABG was 28.2 pre-operatively and became 12.12 post-operatively. In group B, the mean of ABG was 29.72 pre-operatively then became 15.2 post-operatively. Comparing the mean of post-operative ABG between both groups showed statistically significant difference as p value was 0.000496. We found a significant difference of the mean average operative time between both groups as the mean average time for group A was 48.08 min compared to 69.4 min for group B with p value 0.049772295. Conclusions Endoscopic closure of tympanic membrane perforation using Tutoplast is successful short-time procedure avoiding the postauricular or endaural incisions with shorter operative time.