الفهرس | Only 14 pages are availabe for public view |
Abstract The surgical technique that used to restore the integrity of tympanic membrane is myringoplasty. This has many benefits to patients with tympanic membrane perforation that include protection against long-term middle ear damage and migration of squamous epithelium around the margins of perforation with possible consequent cholesteatoma formation. Our 100 patients selected from out-patient’s clinic of ENT department at El- Menoufia University Hospital and presented with dry central tympanic membrane perforation that had microscopic myringoplasty but only 50 patients had otoendoscopic evaluation to middle ear apparatus and the tympanic opening of the ET. The middle ear was examined with an operating microscope in different positions. The visible anatomical areas were evaluated and recorded by performing gentle maneuvers on the patient`s head. The middle ear was evaluated using a zero and 30-degree rigid otoendoscope. After sterilization of the ear, trimming of the perforation edges was done. The margins of perforations were refreshened. Temporalis fascia graft was taken which was placed in an underlay manner medial to handle of malleus via post-aural approach after tympano-meatal flap elevation. Gelfoam soaked in ear drops containing antibiotics was used to stabilize the graft. The mean age of patients was 30.2 years, 42% of patients were male and 58 % of patients were female. In our study, otoendoscopic examination of eustachian tube opening and middle ear status showed non-significant differences compared with microscopic findings in group A. Our study showed a highly significant decrease in postoperative air-bone gap. The success rate in our study was 94% in group A which isn’t statistically significant with 84% success rate in group B. Otoendoscopy is an important tool for assessment of middle ear status and eustachian tube functions during myringoplasty proposing an increase in the success rate. The endoscopic-assisted microscopic myringoplasty had a 94% rate of surgical success for the closure of tympanic membrane defects. The result of this study supports the use of otoendoscopy in traditional microscopic myringoplasty. |