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Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study

Introduction  Middle ear surgeries, including myringoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Objectives  The objective of the present study was to evaluate the graft uptake rate and to evaluate the hearing results. Methods  Thi...

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Autores principales: Shakya, Dipesh, KC, Arun, Nepal, Ajit, Tamang, Nirmala
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805195/
https://www.ncbi.nlm.nih.gov/pubmed/31649765
http://dx.doi.org/10.1055/s-0039-1691758
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author Shakya, Dipesh
KC, Arun
Nepal, Ajit
Tamang, Nirmala
author_facet Shakya, Dipesh
KC, Arun
Nepal, Ajit
Tamang, Nirmala
author_sort Shakya, Dipesh
collection PubMed
description Introduction  Middle ear surgeries, including myringoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Objectives  The objective of the present study was to evaluate the graft uptake rate and to evaluate the hearing results. Methods  This is a prospective study. We have analyzed 139 patients who underwent surgery for chronic otitis media (COM) of the mucosal type. All of the surgeries were performed exclusively under total endoscopic transcanal approach using tragal cartilage as graft, underlay technique. We have evaluated the postoperative graft uptake and performed a hearing evaluation at 6 weeks, at 12 weeks, and at 6 months. Results  During the study period, 139 patients were included, out of which 13 were lost to follow-up; therefore, only 126 patients were assessed. All of the cases were performed under total endoscopic approach. As for the surgical outcome at the postoperative otoscopy, 3 cases had initial uptake at 3 months and failed later; therefore, complete closure of the perforation was observed in 97.6% ( n  = 123) of the patients 6 months after the intervention. Four patients presented with preoperative anacusis; therefore, only 122 patients were included for hearing evaluation. The preoperative air conduction threshold (ACT) and airbone gap (ABG) were 43.34 ± 11.53 and 24.73 ± 7.89, respectively. Postoperatively, the ACT and ABG closure were 28.73 ± 15.75 and 11.91 ± 8.41, respectively. This difference was statistically significant ( p  < 0.001). Conclusion  The endoscopic approach for myringoplasty offers excellent visualization; avoids postaural approach, enables a faster recovery, requires less hospital stay, with excellent graft closure rate and improved functional outcomes.
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spelling pubmed-68051952019-10-24 Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study Shakya, Dipesh KC, Arun Nepal, Ajit Tamang, Nirmala Int Arch Otorhinolaryngol Introduction  Middle ear surgeries, including myringoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Objectives  The objective of the present study was to evaluate the graft uptake rate and to evaluate the hearing results. Methods  This is a prospective study. We have analyzed 139 patients who underwent surgery for chronic otitis media (COM) of the mucosal type. All of the surgeries were performed exclusively under total endoscopic transcanal approach using tragal cartilage as graft, underlay technique. We have evaluated the postoperative graft uptake and performed a hearing evaluation at 6 weeks, at 12 weeks, and at 6 months. Results  During the study period, 139 patients were included, out of which 13 were lost to follow-up; therefore, only 126 patients were assessed. All of the cases were performed under total endoscopic approach. As for the surgical outcome at the postoperative otoscopy, 3 cases had initial uptake at 3 months and failed later; therefore, complete closure of the perforation was observed in 97.6% ( n  = 123) of the patients 6 months after the intervention. Four patients presented with preoperative anacusis; therefore, only 122 patients were included for hearing evaluation. The preoperative air conduction threshold (ACT) and airbone gap (ABG) were 43.34 ± 11.53 and 24.73 ± 7.89, respectively. Postoperatively, the ACT and ABG closure were 28.73 ± 15.75 and 11.91 ± 8.41, respectively. This difference was statistically significant ( p  < 0.001). Conclusion  The endoscopic approach for myringoplasty offers excellent visualization; avoids postaural approach, enables a faster recovery, requires less hospital stay, with excellent graft closure rate and improved functional outcomes. Thieme Revinter Publicações Ltda 2019-10 2019-05-31 /pmc/articles/PMC6805195/ /pubmed/31649765 http://dx.doi.org/10.1055/s-0039-1691758 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Shakya, Dipesh
KC, Arun
Nepal, Ajit
Tamang, Nirmala
Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study
title Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study
title_full Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study
title_fullStr Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study
title_full_unstemmed Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study
title_short Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study
title_sort total endoscopic transcanal cartilage myringoplasty: a prospective study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805195/
https://www.ncbi.nlm.nih.gov/pubmed/31649765
http://dx.doi.org/10.1055/s-0039-1691758
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