Department of Otorhinolaryngology, Dr Ersin Arslan Training and Research Hospital, Eyupoglu Avenue, No: 40, Hurriyet Street, Şahinbey, Gaziantep, 27000, Turkey.
Department of Otorhinolaryngology, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey.
Eur Arch Otorhinolaryngol. 2019 Dec;276(12):3327-3333. doi: 10.1007/s00405-019-05646-8. Epub 2019 Sep 18.
To compare the surgical outcomes of endoscopic transcanal tympanoplasty (ETT) and conventional microscopic tympanoplasty (CMT) in repairing anterior tympanic membrane perforations (ATMPs).
We retrospectively analyzed the graft success rate, hearing outcomes, operative time, hospitalization period and complications in patients who underwent ETT and CMT between October 2015 and July 2018. In addition, the authors investigated whether anterior canal wall protrusion (ACWP) affects the graft success rate and operative time.
The graft success rates for ETT and CMT were 93.7% (30 out of 32 patients) and 91.4% (32 out of 35 patients), respectively (p = 0.640). There was no significant relationship between ACWP and graft success rates in either the endoscopic (p = 0.685) and microscopic (p = 0.894) group. The mean operative time was significantly shorter in the ETT group (37.2 ± 3.1 min) than in the CMT group (52.9 ± 9.2 min) (p < 0.001). Regarding operative time, there was no statistically significant difference between patients with and without ACWP (38.3 versus 36.3 min, respectively (p = 0.124)) in the ETT group. However, the mean operative time of patients with ACWP in the CMT group was significantly longer than patients without ACWP [62.3 versus 48.8 min, respectively (p < 0.001)].
ETT offering fewer complication rates and shorter duration of surgery may serve as a reasonable alternative to CMT in repairing ATMPs, with comparable graft success rates.
比较内镜经耳道鼓膜成形术（ETT）和传统显微镜下鼓膜成形术（CMT）修复前鼓膜穿孔（ATMP）的手术效果。
我们回顾性分析了 2015 年 10 月至 2018 年 7 月期间接受 ETT 和 CMT 治疗的患者的移植物成功率、听力结果、手术时间、住院时间和并发症，并调查了前鼓室壁突出（ACWP）是否影响移植物成功率和手术时间。
ETT 和 CMT 的移植物成功率分别为 93.7%（32 例中的 30 例）和 91.4%（35 例中的 32 例）（p=0.640）。在 ETT 组（p=0.685）和显微镜组（p=0.894）中，ACWP 与移植物成功率之间均无显著关系。ETT 组的平均手术时间明显短于 CMT 组（37.2±3.1 分钟比 52.9±9.2 分钟）（p<0.001）。关于手术时间，在 ETT 组中，有和没有 ACWP 的患者之间没有统计学上的显著差异（分别为 38.3 分钟和 36.3 分钟）（p=0.124）。然而，CMT 组中存在 ACWP 的患者的平均手术时间明显长于不存在 ACWP 的患者[分别为 62.3 分钟和 48.8 分钟，（p<0.001）]。
ETT 并发症发生率低，手术时间短，可作为修复 ATMP 的一种合理替代方案，其移植物成功率与 CMT 相当。
