Endoscopic transcanal transtympanic myringoplasty vs. endoscopic transcanal tympanoplasty - 1-year follow-up study

Sep 29, 2026

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Endoscopic transcanal transtympanic myringoplasty (ETTM) is positioned as a comparatively easier option than endoscopic transcanal tympanoplasty (ETT) for tympanic membrane perforations, yet direct 1-year outcome comparisons after grafting with tragal perichondrium were lacking. This study evaluated hearing and perforation outcomes using pure-tone audiometry and otoscopic assessment before surgery and at least 1 year after surgery.

LanguageEnglish

CategoryHealthcare

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Pages7

Reading Time18 min

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Abstract

Background

Methods

Results

Conclusion

INTRODUCTION

J Chin MedAssoc Original article Endoscopic transcanal transtympanic myringoplasty vs. endoscopic transcanal tympanoplasty: 1-year follow-up study Chin-Kuo Chena,b,c, Chin-Lung Kuod, Yu-Ting Wenge, Li-Chun Hsiehf,g,* aDepartment of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC; bSchool of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC; cDepartment of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC; dDepartment of Otolaryngology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; eSchcool of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC; fDepartment of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan, ROC; gDepartment of Audiology and Speech Language Pathology, Mackay Medical College, New Taipei City, Taiwan, ROC Abstract Background: Endoscopic transcanal transtympanic myringoplasty (ETTM) is a relatively easier technique than endoscopic transcanal tympanoplasty (ETT) for repairing tympanic membrane perforations. No studies have compared the outcomes of these two procedures with tragal perichondrium after 1-year. Furthermore, there is no evidence-based stratification according to variations in perforation size in endoscopic ear surgery. Therefore, we compared the 1-year outcomes of ETTM and ETT stratified according to perforation size. Methods: Patients who underwent ETT and ETTM to repair eardrum perforations with a tragal perichondrium graft were identified. Pure-tone audiometric tests and otoscopic examination were performed to assess hearing outcomes and perforation sizes both preoperatively and at least 1 year postoperatively. Results: In total, 158 patients (159 ears) were included. ETT was performed on 83 ears, and ETTM was performed on 76 ears. The ETTM procedure time was 10-minutes shorter than that for ETT (p < 0.001) . Perforation size was significantly correlated with graft take-rate. For large perforations, the ETT success rate was significantly higher than that of ETTM (91 .7% vs. 78.9%) . Success rates for small-medium perforations were comparable for both methods (p > 0.05) . However, for medium perforations, the graft take-rate of ETT reached a plateau after 6 months, while that of ETTM gradually declined during the 12-month follow-up. Both groups had a comparable mean postoperative air-bone gap gain (p = 0.666) . Conclusion: ETTM is suitable for repairing small perforations, whereas ETT is preferred for large perforations. Both methods, and particularly ETTM, should be employed cautiously for medium perforations. Keywords: Endoscopic ear surgery; Myringoplasty; Tragal perichondrium; Transcanal; Tympanoplasty 1. INTRODUCTION Microscopic tympanoplasty can be used to repair any size perforation; canalplasty may be performed. As the endoscope offers greater accessibility to the narrow external auditory meatus, exclusive endoscopic tympanoplasty has become more popular in recent years.1–6 Tympanoplasty can be done with overlay or underlay techniques according to the graft position. Underlay techniques consist of two major approaches: type 1 * Address correspondence. Dr. Li-Chun Hsieh, Department of OtolaryngologyHead and Neck Surgery, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei 104, Taiwan, ROC. E-mail address: [lichunhsieh1978@gmail.com](lichunhsieh1978@gmail.com) (L.-C. Hsieh). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2022) 85: 1017-1023. Received February 28, 2022; accepted May 5, 2022. doi: 10. 1097/JCMA.0000000000000777. Copyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([h

FAQs

What was the main aim of comparing ETTM and ETT in this 1-year follow-up study?

To compare 1-year outcomes of ETTM and ETT when repairing tympanic membrane perforations using a tragal perichondrium graft, including stratification by perforation size.

How were hearing outcomes and perforation outcomes assessed?

Pure-tone audiometric tests and otoscopic examination were used to assess hearing outcomes and perforation size before surgery and at least 1 year after surgery.

Which procedure performed better for large perforations?

For large perforations, the ETT success rate was significantly higher than ETTM (91.7% vs. 78.9%).

Sep 29, 2026

Uploaded by Jake