Endoscopic transcanal myringoplasty with anterior tab flap underlay technique: An analysis of 35 cases

INTRODUCTION: The repair of the tympanic membrane can present a problem, especially in anterior perforation, because the anterior portion was not enough to inadequate contact between tympanic membrane remnant and graft. Various surgical techniques were recommended to achieve an acceptable graft success rate in anterior perforation. Endoscopic transcanal myringoplasty with anterior tab flap could provide the better stability of the graft. OBJECTIVE: The aim of this study was to report the minimally invasive technique for the anterior tympanic membrane perforation closure and investigate the graft success rate of this technique. PATIENTS AND METHODS: We performed a prospective, randomized study of 35 patients who consulted the otorhinolaryngology department at the university hospital for surgery of perforation tympanic membrane repair. RESULTS: The average age was 35.1 ± 11.9 years. The size of the perforation was dominant at small-size and large-size, 51.4%, 34.3%, respectively. There was a significant difference between the Preoperative air conduction of small and large perforations (34.44 8.68 and 49.79 14.54, respectively). Of 35 patients, 31 (88.6%) had closure of their perforations. The mean preoperative ABG was 24.11 ± 10.79 dB, while The mean postoperative ABG was 13.97 ± 10.03 dB (p < 0.05). Approximately 34.3% patients had ABG within 20 dB preoperatively, which increased to 82.9% after intervention (p < 0.05). CONCLUSIONS: The endoscopic transcanal myringoplasty with anterior tab flap underlay technique is a safe, suitable and effective method for cases with anterior tympanic membrane perforations, and showed improvement in postoperative hearing.