Skip to main content
Erschienen in: HNO 10/2021

26.05.2021 | Leitthema

Totally endoscopic tympanic membrane repair

verfasst von: Prof. Dr. Adrian L James

Erschienen in: HNO | Ausgabe 10/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

Transcanal totally endoscopic ear surgery (TEES) has become increasingly popular internationally; however, for surgeons trained with a two-handed microscope-guided approach, the potential challenges of adopting TEES can appear off-putting.

Objectives

This article outlines the pros and cons of TEES for tympanic membrane repair and describes aspects of surgical technique relevant to those who might adopt this approach.

Materials and methods

Data are provided from the author’s experience along with a review of relevant literature, including several meta-analyses of tympanoplasty outcome.

Results

Meta-analyses show that TEES tympanoplasty is as effective at closing tympanic membrane perforations and improving hearing as microscope-guided surgery. Yet patients benefit from avoidance of a skin incision and faster recovery.

Conclusion

Repair of the tympanic membrane with TEES is feasible and effective. This minimally invasive approach is very appealing to patients.
Literatur
1.
Zurück zum Zitat Anzola JF, Nogueira JF (2016) Endoscopic techniques in tympanoplasty. Otolaryngol Clin North Am 49:1253–1264 CrossRef Anzola JF, Nogueira JF (2016) Endoscopic techniques in tympanoplasty. Otolaryngol Clin North Am 49:1253–1264 CrossRef
2.
Zurück zum Zitat Ayache S, Beltran M, Guevara N (2019) Endoscopic classification of the external auditory canal for transcanal endoscopic ear surgery. Eur Ann Otorhinolaryngol Head Neck Dis 136:247–250 CrossRef Ayache S, Beltran M, Guevara N (2019) Endoscopic classification of the external auditory canal for transcanal endoscopic ear surgery. Eur Ann Otorhinolaryngol Head Neck Dis 136:247–250 CrossRef
3.
Zurück zum Zitat Baruah P, Lee JDE, Pickering C et al (2020) The learning curve for endoscopic tympanoplasties: a single-institution experience, in Birmingham, UK. J Laryngol Otol 134:431–433 CrossRef Baruah P, Lee JDE, Pickering C et al (2020) The learning curve for endoscopic tympanoplasties: a single-institution experience, in Birmingham, UK. J Laryngol Otol 134:431–433 CrossRef
4.
Zurück zum Zitat Chen CK, Hsieh LC (2020) Clinical outcome of exclusive endoscopic tympanoplasty with porcine small intestine submucosa in 72 patients. Clin Otolaryngol 45:938–943 CrossRef Chen CK, Hsieh LC (2020) Clinical outcome of exclusive endoscopic tympanoplasty with porcine small intestine submucosa in 72 patients. Clin Otolaryngol 45:938–943 CrossRef
5.
Zurück zum Zitat D’Eredita R (2015) Porcine small intestinal submucosa (SIS) myringoplasty in children: a randomized controlled study. Int J Pediatr Otorhinolaryngol 79:1085–1089 CrossRef D’Eredita R (2015) Porcine small intestinal submucosa (SIS) myringoplasty in children: a randomized controlled study. Int J Pediatr Otorhinolaryngol 79:1085–1089 CrossRef
6.
Zurück zum Zitat De Zinis LO, Berlucchi M, Nassif N (2017) Double-handed endoscopic myringoplasty with a holding system in children: preliminary observations. Int J Pediatr Otorhinolaryngol 96:127–130 CrossRef De Zinis LO, Berlucchi M, Nassif N (2017) Double-handed endoscopic myringoplasty with a holding system in children: preliminary observations. Int J Pediatr Otorhinolaryngol 96:127–130 CrossRef
7.
Zurück zum Zitat Dixon PR, James AL (2020) Evaluation of residual disease following transcanal totally endoscopic vs postauricular surgery among children with middle ear and attic cholesteatoma. JAMA Otolaryngol Head Neck Surg 146:408–413 CrossRef Dixon PR, James AL (2020) Evaluation of residual disease following transcanal totally endoscopic vs postauricular surgery among children with middle ear and attic cholesteatoma. JAMA Otolaryngol Head Neck Surg 146:408–413 CrossRef
9.
Zurück zum Zitat Hardman J, Muzaffar J, Nankivell P et al (2015) Tympanoplasty for chronic tympanic membrane perforation in children: systematic review and meta-analysis. Otol Neurotol 36:796–804 CrossRef Hardman J, Muzaffar J, Nankivell P et al (2015) Tympanoplasty for chronic tympanic membrane perforation in children: systematic review and meta-analysis. Otol Neurotol 36:796–804 CrossRef
10.
Zurück zum Zitat Hellstrom S, Salen B, Stenfors LE (1983) Absorbable gelatin sponge (Gelfoam) in otosurgery: one cause of undesirable postoperative results? Acta Otolaryngol 96:269–275 CrossRef Hellstrom S, Salen B, Stenfors LE (1983) Absorbable gelatin sponge (Gelfoam) in otosurgery: one cause of undesirable postoperative results? Acta Otolaryngol 96:269–275 CrossRef
11.
Zurück zum Zitat Ito T, Kubota T, Watanabe T et al (2015) Transcanal endoscopic ear surgery for pediatric population with a narrow external auditory canal. Int J Pediatr Otorhinolaryngol 79:2265–2269 CrossRef Ito T, Kubota T, Watanabe T et al (2015) Transcanal endoscopic ear surgery for pediatric population with a narrow external auditory canal. Int J Pediatr Otorhinolaryngol 79:2265–2269 CrossRef
12.
Zurück zum Zitat Ito T, Mochizuki H, Watanabe T et al (2014) Safety of ultrasonic bone curette in ear surgery by measuring skull bone vibrations. Otol Neurotol 35:e135–139 CrossRef Ito T, Mochizuki H, Watanabe T et al (2014) Safety of ultrasonic bone curette in ear surgery by measuring skull bone vibrations. Otol Neurotol 35:e135–139 CrossRef
13.
Zurück zum Zitat Jalali MM, Motasaddi M, Kouhi A et al (2017) Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 127:2139–2148 CrossRef Jalali MM, Motasaddi M, Kouhi A et al (2017) Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 127:2139–2148 CrossRef
14.
Zurück zum Zitat James AL (2017) Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome. Laryngoscope 127:2659–2664 CrossRef James AL (2017) Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome. Laryngoscope 127:2659–2664 CrossRef
15.
Zurück zum Zitat James AL, Papsin BC (2012) Ten top considerations in pediatric tympanoplasty. Otolaryngol Head Neck Surg 147:992–998 CrossRef James AL, Papsin BC (2012) Ten top considerations in pediatric tympanoplasty. Otolaryngol Head Neck Surg 147:992–998 CrossRef
16.
Zurück zum Zitat Khan MM, Parab SR (2016) Endoscopic cartilage tympanoplasty: a two-handed technique using an endoscope holder. Laryngoscope 126:1893–1898 CrossRef Khan MM, Parab SR (2016) Endoscopic cartilage tympanoplasty: a two-handed technique using an endoscope holder. Laryngoscope 126:1893–1898 CrossRef
17.
Zurück zum Zitat Kozin ED, Lehmann A, Carter M et al (2014) Thermal effects of endoscopy in a human temporal bone model: implications for endoscopic ear surgery. Laryngoscope 124:e332–339 CrossRef Kozin ED, Lehmann A, Carter M et al (2014) Thermal effects of endoscopy in a human temporal bone model: implications for endoscopic ear surgery. Laryngoscope 124:e332–339 CrossRef
18.
Zurück zum Zitat Kwinter A, Purcell PL, Leonard CL et al (2021) Comparing transcanal endoscopic surgery to post-auricular microscope-guided surgery in pediatric ossiculoplasty: hearing outcomes and post-operative pain. Otol Neurotol. (in press) Kwinter A, Purcell PL, Leonard CL et al (2021) Comparing transcanal endoscopic surgery to post-auricular microscope-guided surgery in pediatric ossiculoplasty: hearing outcomes and post-operative pain. Otol Neurotol. (in press)
19.
Zurück zum Zitat Lai P, Propst EJ, Papsin BC (2006) Lateral graft type 1 tympanoplasty using AlloDerm for tympanic membrane reconstruction in children. Int J Pediatr Otorhinolaryngol 70:1423–1429 CrossRef Lai P, Propst EJ, Papsin BC (2006) Lateral graft type 1 tympanoplasty using AlloDerm for tympanic membrane reconstruction in children. Int J Pediatr Otorhinolaryngol 70:1423–1429 CrossRef
20.
Zurück zum Zitat Lee SY, Lee DY, Seo Y et al (2019) Can endoscopic tympanoplasty be a good alternative to microscopic tympanoplasty? A systematic review and meta-analysis. Clin Exp Otorhinolaryngol 12:145–155 CrossRef Lee SY, Lee DY, Seo Y et al (2019) Can endoscopic tympanoplasty be a good alternative to microscopic tympanoplasty? A systematic review and meta-analysis. Clin Exp Otorhinolaryngol 12:145–155 CrossRef
21.
Zurück zum Zitat Mok F, Leonard CG, Adams MA et al (2020) Total endoscopic ear surgery in management of cochleocele: a case series. Int J Pediatr Otorhinolaryngol 135:110109 CrossRef Mok F, Leonard CG, Adams MA et al (2020) Total endoscopic ear surgery in management of cochleocele: a case series. Int J Pediatr Otorhinolaryngol 135:110109 CrossRef
22.
Zurück zum Zitat Pap I, Tóth I, Gede N et al (2019) Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—a meta-analysis. Clin Otolaryngol 44:942–953 CrossRef Pap I, Tóth I, Gede N et al (2019) Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—a meta-analysis. Clin Otolaryngol 44:942–953 CrossRef
24.
Zurück zum Zitat Saliba I, Woods O (2011) Hyaluronic acid fat graft myringoplasty: a minimally invasive technique. Laryngoscope 121:375–380 CrossRef Saliba I, Woods O (2011) Hyaluronic acid fat graft myringoplasty: a minimally invasive technique. Laryngoscope 121:375–380 CrossRef
25.
Zurück zum Zitat Siu JM, Negandhi J, Harrison RV et al (2021) Cochlear structure and function after ultrasonic bone removal from the ossicular chain. J Otolaryngol Head Neck Surg 50:1–8 Siu JM, Negandhi J, Harrison RV et al (2021) Cochlear structure and function after ultrasonic bone removal from the ossicular chain. J Otolaryngol Head Neck Surg 50:1–8
26.
Zurück zum Zitat Tan HE, Santa Maria PL, Eikelboom RH et al (2016) Type I tympanoplasty meta-analysis: a single variable analysis. Otol Neurotol 37:838–846 CrossRef Tan HE, Santa Maria PL, Eikelboom RH et al (2016) Type I tympanoplasty meta-analysis: a single variable analysis. Otol Neurotol 37:838–846 CrossRef
27.
Zurück zum Zitat Tseng CC, Lai MT, Wu CC et al (2017) Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: a systematic review and meta-analysis. Laryngoscope 127:1890–1896 CrossRef Tseng CC, Lai MT, Wu CC et al (2017) Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: a systematic review and meta-analysis. Laryngoscope 127:1890–1896 CrossRef
28.
Zurück zum Zitat Vos JD, Latev MD, Labadie RF et al (2005) Use of AlloDerm in type I tympanoplasty: a comparison with native tissue grafts. Laryngoscope 115:1599–1602 CrossRef Vos JD, Latev MD, Labadie RF et al (2005) Use of AlloDerm in type I tympanoplasty: a comparison with native tissue grafts. Laryngoscope 115:1599–1602 CrossRef
29.
Zurück zum Zitat Yang T, Wu X, Peng X et al (2016) Comparison of cartilage graft and fascia in type 1 tympanoplasty: systematic review and meta-analysis. Acta Otolaryngol 136:1085–1090 CrossRef Yang T, Wu X, Peng X et al (2016) Comparison of cartilage graft and fascia in type 1 tympanoplasty: systematic review and meta-analysis. Acta Otolaryngol 136:1085–1090 CrossRef
30.
Zurück zum Zitat Yawn RJ, Carlson ML, Haynes DS et al (2014) Lateral-to-malleus underlay tympanoplasty: surgical technique and outcomes. Otol Neurotol 35:1809–1812 CrossRef Yawn RJ, Carlson ML, Haynes DS et al (2014) Lateral-to-malleus underlay tympanoplasty: surgical technique and outcomes. Otol Neurotol 35:1809–1812 CrossRef
31.
Zurück zum Zitat Yawn RJ, Dedmon MM, O’connell BP et al (2018) Tympanic membrane perforation repair using porcine small intestinal submucosal grafting. Otol Neurotol 39:e332–e335 CrossRef Yawn RJ, Dedmon MM, O’connell BP et al (2018) Tympanic membrane perforation repair using porcine small intestinal submucosal grafting. Otol Neurotol 39:e332–e335 CrossRef
Metadaten
Titel
Totally endoscopic tympanic membrane repair
verfasst von
Prof. Dr. Adrian L James
Publikationsdatum
26.05.2021
Verlag
Springer Medizin
Erschienen in
HNO / Ausgabe 10/2021
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-021-01052-x

Weitere Artikel der Ausgabe 10/2021

HNO 10/2021 Zur Ausgabe

Repetitorium Facharztprüfung

Vorbereitung zur Facharztprüfung HNO

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update HNO und bleiben Sie gut informiert – ganz bequem per eMail.