Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South Korea
Objectives. Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to smal...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Otorhinolaryngology-Head and Neck Surgery
2023-05-01
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| Series: | Clinical and Experimental Otorhinolaryngology |
| Subjects: | |
| Online Access: | http://www.e-ceo.org/upload/pdf/ceo-2022-01599.pdf |
| _version_ | 1797821476316905472 |
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| author | Sung-Won Choi Il Joon Moon Ji Eun Choi Woo Seok Kang In Seok Moon Soo-Keun Kong Hyong Ho Cho Il-Woo Lee Jong Woo Chung Dong Gu Hur Jong Dae Lee |
| author_facet | Sung-Won Choi Il Joon Moon Ji Eun Choi Woo Seok Kang In Seok Moon Soo-Keun Kong Hyong Ho Cho Il-Woo Lee Jong Woo Chung Dong Gu Hur Jong Dae Lee |
| author_sort | Sung-Won Choi |
| collection | DOAJ |
| description | Objectives. Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations. Methods. This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data. Results. In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable results. Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, –11.351; 95% confidence interval, –21.491 to –1.212; P=0.028). Conclusion. This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations. |
| first_indexed | 2024-03-13T09:53:15Z |
| format | Article |
| id | doaj.art-19722c173b6a4a9187b73c174f88c092 |
| institution | Directory Open Access Journal |
| issn | 1976-8710 2005-0720 |
| language | English |
| last_indexed | 2024-03-13T09:53:15Z |
| publishDate | 2023-05-01 |
| publisher | Korean Society of Otorhinolaryngology-Head and Neck Surgery |
| record_format | Article |
| series | Clinical and Experimental Otorhinolaryngology |
| spelling | doaj.art-19722c173b6a4a9187b73c174f88c0922023-05-24T05:26:20ZengKorean Society of Otorhinolaryngology-Head and Neck SurgeryClinical and Experimental Otorhinolaryngology1976-87102005-07202023-05-0116212513110.21053/ceo.2022.01599859Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South KoreaSung-Won Choi0Il Joon Moon1Ji Eun Choi2Woo Seok Kang3In Seok Moon4Soo-Keun Kong5Hyong Ho Cho6Il-Woo Lee7Jong Woo Chung8Dong Gu Hur9Jong Dae Lee10Korean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaKorean Endoscopic Ear Surgery Study Group, Seoul, KoreaObjectives. Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations. Methods. This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data. Results. In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable results. Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, –11.351; 95% confidence interval, –21.491 to –1.212; P=0.028). Conclusion. This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations.http://www.e-ceo.org/upload/pdf/ceo-2022-01599.pdftympanic membrane perforationminimally invasive surgeryendoscopytympanoplasty |
| spellingShingle | Sung-Won Choi Il Joon Moon Ji Eun Choi Woo Seok Kang In Seok Moon Soo-Keun Kong Hyong Ho Cho Il-Woo Lee Jong Woo Chung Dong Gu Hur Jong Dae Lee Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South Korea Clinical and Experimental Otorhinolaryngology tympanic membrane perforation minimally invasive surgery endoscopy tympanoplasty |
| title | Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South Korea |
| title_full | Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South Korea |
| title_fullStr | Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South Korea |
| title_full_unstemmed | Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South Korea |
| title_short | Outcomes of Endoscopic Tympanoplasty for Large Perforations: A Multicenter Retrospective Study in South Korea |
| title_sort | outcomes of endoscopic tympanoplasty for large perforations a multicenter retrospective study in south korea |
| topic | tympanic membrane perforation minimally invasive surgery endoscopy tympanoplasty |
| url | http://www.e-ceo.org/upload/pdf/ceo-2022-01599.pdf |
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