Makwana Parth, Prajapati Viral, Makadiya Vivek
Department of ENT, Nootan Medical College, Visnagar, Gujarat, India.
Department of ENT, Dr. M. K.Shah Medical College, Ahmedabad, Gujarat, India.
Iran J Otorhinolaryngol. 2025;37(5):261-266. doi: 10.22038/ijorl.2025.83887.3826.
Recently use of endoscopes for ear surgeries is being popular among the surgeons as it gives a wide view of the middle ear. Also, tympanoplasty by transcanal approach can be done as a day care procedure and so it reduces the cost of hospitalization. The study was aimed to evaluate the results of type 1 tympanoplasty done by endoscopic transcanal approach with cartilage perichondrium graft, in relation to successful graft take-up rate and improvement in hearing.
Total 50 patients were included in the study and all of them underwent type 1 tympanoplasty by endoscopic transcanal approach. Tragal cartilage with its attached perichondrium on one side facing laterally was placed as graft lateral to handle of malleus with v shaped notch at 12 o clock by underlay technique in all the cases. Patients were called for regular follow-up, and they were observed for successful graft take-up and improvement in hearing at 3 months after procedure.
Out of 50 cases complete closure was achieved in 46 cases which makes a success rate of 92%. The average improvement in hearing of 15.3 dB was noted.
Endoscopic Transcanal approach with cartilage-perichondrium graft for tympanoplasty (type 1) is effective in terms of successful graft take-up rate and improvement in hearing, very cost effective, faster in terms of surgical time, and has less postoperative morbidity so gives better quality of life to the patient.
近年来，内窥镜在耳部手术中的应用在外科医生中越来越普遍，因为它能提供中耳的广阔视野。此外，经耳道入路的鼓室成形术可作为日间手术进行，因此降低了住院费用。本研究旨在评估采用内窥镜经耳道入路并使用软骨-软骨膜移植物进行Ⅰ型鼓室成形术的效果，包括移植物成功植入率和听力改善情况。
本研究共纳入50例患者，所有患者均接受了内窥镜经耳道入路的Ⅰ型鼓室成形术。在所有病例中，均采用衬里技术，将一侧朝外附着有软骨膜的耳屏软骨放置在锤骨柄外侧，在12点位置有一个V形切口。患者被要求定期随访，并在术后3个月观察移植物是否成功植入以及听力是否改善。
50例病例中，46例实现了完全封闭，成功率为92%。听力平均提高了15.3分贝。
采用内窥镜经耳道入路并使用软骨-软骨膜移植物进行鼓室成形术（Ⅰ型），在移植物成功植入率和听力改善方面是有效的，成本效益非常高，手术时间更快，术后发病率更低，因此能为患者提供更好的生活质量。
