Outcomes of Endoscopic Tympanoplasty for Large Perforations : A Multicenter Retrospective Study in South Korea
OBJECTIVES: Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations.
METHODS: This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data.
RESULTS: In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable.
RESULTS: Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, -11.351; 95% confidence interval, -21.491 to -1.212; P=0.028).
CONCLUSION: This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Clinical and experimental otorhinolaryngology - 16(2023), 2 vom: 01. Mai, Seite 125-131 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Choi, Sung-Won [VerfasserIn] |
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| Links: |
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| Themen: |
Endoscopy |
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| Anmerkungen: |
Date Revised 27.05.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.21053/ceo.2022.01599 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM353284424 |
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| 100 | 1 | |a Choi, Sung-Won |e verfasserin |4 aut | |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a OBJECTIVES: Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations | ||
| 520 | |a METHODS: This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data | ||
| 520 | |a RESULTS: In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable | ||
| 520 | |a RESULTS: Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, -11.351; 95% confidence interval, -21.491 to -1.212; P=0.028) | ||
| 520 | |a CONCLUSION: This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Endoscopy | |
| 650 | 4 | |a Minimally Invasive Surgery | |
| 650 | 4 | |a Tympanic Membrane Perforation | |
| 650 | 4 | |a Tympanoplasty | |
| 700 | 1 | |a Moon, Il Joon |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Ji Eun |e verfasserin |4 aut | |
| 700 | 1 | |a Kang, Woo Seok |e verfasserin |4 aut | |
| 700 | 1 | |a Moon, In Seok |e verfasserin |4 aut | |
| 700 | 1 | |a Kong, Soo-Keun |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Hyong Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Il-Woo |e verfasserin |4 aut | |
| 700 | 1 | |a Chung, Jong Woo |e verfasserin |4 aut | |
| 700 | 1 | |a Hur, Dong Gu |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jong Dae |e verfasserin |4 aut | |
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