De Zinis L O Redaelli, Berlucchi M, Nassif N
Department of Pediatric Otorhinolaryngology, University of Bescia, Brescia, Italy.
Department of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy.
Int J Pediatr Otorhinolaryngol. 2017 May;96:127-130. doi: 10.1016/j.ijporl.2017.03.017. Epub 2017 Mar 16.
Endoscopic transcanal myringoplasty is a newly-introduced technique for reconstruction of tympanic membrane perforation that offers the advantage to obviate postauricular incision. The objective of this study was to evaluate the feasibility of a double-handed endoscope holder transcanal myringoplasty in children. This technique permits bimanual execution of the procedure and allows the surgeon to overcome the two significant issues of single-handed endoscope surgery, i.e. easy domination of a bloody field and smooth introduction of the graft.
A prospective non-randomized study of 10 consecutive primary endoscope holder-aided myringoplasties was performed; 3 mm or 4 mm 0° rigid endoscopes were used. A xenograft, biologic soft tissue, was applied in all cases.
All procedures were performed successfully. Duration of surgery was faster than with a single-handed procedure and varied between 20 and 60 min. The tympanic membrane healed successfully in all patients.
In this preliminary experience in children, a bimanual endoscopic holder-aided myringoplasty technique offers the possibility to overcome the obstacles encountered in a single-handed technique, since it can replicate the same concept of a bimanual microscopic approach and allow for easy management of a bloody field and introduction of the graft in the middle ear.
内镜经耳道鼓膜成形术是一种新引入的鼓膜穿孔重建技术，其优点是无需耳后切口。本研究的目的是评估双手持内镜经耳道鼓膜成形术在儿童中的可行性。该技术允许双手操作手术，并使外科医生能够克服单手内镜手术的两个重大问题，即易于控制出血区域和平滑植入移植物。
对连续10例原发性持内镜辅助鼓膜成形术进行前瞻性非随机研究；使用3毫米或4毫米0°硬性内镜。所有病例均应用异种移植物，即生物软组织。
所有手术均成功完成。手术时间比单手手术更快，在20至60分钟之间。所有患者的鼓膜均成功愈合。
在儿童的这一初步经验中，双手持内镜辅助鼓膜成形术技术提供了克服单手技术中遇到的障碍的可能性，因为它可以复制双手显微镜手术的相同概念，并便于控制出血区域和将移植物植入中耳。
