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Purpose <p>Bleeding is one of the most challenging issues for surgeons performing endoscopic tympanoplasty. During creation and elevation of the tympanomeatal flap (TMF) prevention or control of bleeding greatly facilitates the safety and comfort in the next steps of the surgery. The aim of this study was to compare the effects of cautery versus cold instrumentation during creation of TMF at endoscopic tympanoplasty surgery.</p> Methods <p>We investigated 24 patients TMF created with cautery and 24 patients with cold instrument, and compared bleeding scores, operation time, postoperative hearing and complications between groups.</p> Results <p>The mean bleeding score was signifcantly lower in cautery incised patients compared to cold instrument patients (1,88 ± 0.61 vs. 3,67 ± 0.64, p &lt; 0.001). Mean duration of surgery was also significantly shorter in cautery used patients (36,00 ± 4.41vs. 47,67 ± 2.09&#xa0;min, p &lt; 0.001).</p> Conclusion <p>In conclusion, current data suggest that the electrocautery dissection technique reduces operative time without increasing the risk of complications, thereby improving surgical efficiency and minimizing intraoperative bleeding. Additionally, neither technique appears to have a significant impact on graft success. Therefore, the choice of technique should be guided by the surgeon’s expertise and the patient’s specific clinical condition.</p>

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The optimizing endoscopic tympanoplasty: The role of dissection technique

  • 期刊论文

  • 发表日期：

    2026年2月16日

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  • Berkay Güzel,
  • Ahmet Baki,
  • Özgür Yiğit,
  • Şahin Öğreden,
  • Zeliha Kapusuz Gencer,
  • İskender Bayram

摘要

Purpose

Bleeding is one of the most challenging issues for surgeons performing endoscopic tympanoplasty. During creation and elevation of the tympanomeatal flap (TMF) prevention or control of bleeding greatly facilitates the safety and comfort in the next steps of the surgery. The aim of this study was to compare the effects of cautery versus cold instrumentation during creation of TMF at endoscopic tympanoplasty surgery.

Methods

We investigated 24 patients TMF created with cautery and 24 patients with cold instrument, and compared bleeding scores, operation time, postoperative hearing and complications between groups.

Results

The mean bleeding score was signifcantly lower in cautery incised patients compared to cold instrument patients (1,88 ± 0.61 vs. 3,67 ± 0.64, p < 0.001). Mean duration of surgery was also significantly shorter in cautery used patients (36,00 ± 4.41vs. 47,67 ± 2.09 min, p < 0.001).

Conclusion

In conclusion, current data suggest that the electrocautery dissection technique reduces operative time without increasing the risk of complications, thereby improving surgical efficiency and minimizing intraoperative bleeding. Additionally, neither technique appears to have a significant impact on graft success. Therefore, the choice of technique should be guided by the surgeon’s expertise and the patient’s specific clinical condition.