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Background <p>Myringoplasty is the surgery done for repair of tympanic membraneperforation. It can be performed using either endoscopic or microscopic techniques.With advent of endoscopy systems, endoscopic ear surgery is becoming a goodalternative to conventional microscopic ear surgery with advantages of bettervisualization, less operative time and pain. In push-through endoscopic myringoplasty,tympanic membrane perforation is repaired by technique of advancing the cartilagegraft through perforation without elevating tymapanomeatal flap. It is also known asTriple C technique (composite chondroperichondrial clip technique), Island cartilagetechnique or butterfly technique. Then perichondrium is elevated from cartilage allaround except at its centre. Graft is placed in such a way that the cartilage lies medialto the perforation margin while perichondrium lies lateral to the perforation margin.This is a composite (cartilage-perichondrium) graft. In this study, we report ouroutcomes of the push-through endoscopic myringoplasty technique, aiming to analyzethe rate of graft success, hearing outcomes and complications.</p> Aim <p>To evaluate theefficacy of push-through endoscopic myringoplasty method with regards to hearingimprovement, graft uptake rate and complications.</p> Material and Methods <p>Prospectivestudy was conducted from December 2022 to September 2023 at Department of ENT atBharatratna Doctor Babasaheb Ambedkar Municipal General Hospital, Kandivali.Patients were enrolled following comprehensive preoperative assessment and provisionof informed written consent. Tympanic membrane perforation was repaired bytechnique of advancing the cartilage graft through perforation without elevatingtymapanomeatal flap.</p> Results <p>A total of 25 cases were included in the present study.The age of the patients ranged from 21 to 60 years, with mean age of 35 years.Maximum number of patients were in the age group of 25 to 35years. 09 patients (36%)were male and 16 patients (64%) were female. The overall mean preoperative air bonegap was 26.46 dB and overall mean post-operative air bone gap was reduced to 14.8 dBwith mean hearing improvement of 11.66 dB. Only two patients showed graft failure,thus making the graft success rate of 92%.</p> Conclusion <p>Push-through endoscopicmyringoplasty is a less invasive technique of cartilage myringoplasty which has goodsuccess rate in terms of both graft uptake and hearing gain. The mean preoperative airbone gap of 26.46 dB was reduced to14.8 dB, with mean hearing improvement of 11.66dB. The technique achieved graft success rate of 92% with low complication profile.</p>

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Push-Through Endoscopic Myringoplasty for Chronic Otitis Media Mucosal Disease: Our Clinical Experience

  • 期刊论文

  • 发表日期：

    2025年10月14日

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  • Reshma P. Bangar,
  • Tejashri S. Aher,
  • Harshada S. Kurande,
  • Rajesh Yadav

摘要

Background

Myringoplasty is the surgery done for repair of tympanic membraneperforation. It can be performed using either endoscopic or microscopic techniques.With advent of endoscopy systems, endoscopic ear surgery is becoming a goodalternative to conventional microscopic ear surgery with advantages of bettervisualization, less operative time and pain. In push-through endoscopic myringoplasty,tympanic membrane perforation is repaired by technique of advancing the cartilagegraft through perforation without elevating tymapanomeatal flap. It is also known asTriple C technique (composite chondroperichondrial clip technique), Island cartilagetechnique or butterfly technique. Then perichondrium is elevated from cartilage allaround except at its centre. Graft is placed in such a way that the cartilage lies medialto the perforation margin while perichondrium lies lateral to the perforation margin.This is a composite (cartilage-perichondrium) graft. In this study, we report ouroutcomes of the push-through endoscopic myringoplasty technique, aiming to analyzethe rate of graft success, hearing outcomes and complications.

Aim

To evaluate theefficacy of push-through endoscopic myringoplasty method with regards to hearingimprovement, graft uptake rate and complications.

Material and Methods

Prospectivestudy was conducted from December 2022 to September 2023 at Department of ENT atBharatratna Doctor Babasaheb Ambedkar Municipal General Hospital, Kandivali.Patients were enrolled following comprehensive preoperative assessment and provisionof informed written consent. Tympanic membrane perforation was repaired bytechnique of advancing the cartilage graft through perforation without elevatingtymapanomeatal flap.

Results

A total of 25 cases were included in the present study.The age of the patients ranged from 21 to 60 years, with mean age of 35 years.Maximum number of patients were in the age group of 25 to 35years. 09 patients (36%)were male and 16 patients (64%) were female. The overall mean preoperative air bonegap was 26.46 dB and overall mean post-operative air bone gap was reduced to 14.8 dBwith mean hearing improvement of 11.66 dB. Only two patients showed graft failure,thus making the graft success rate of 92%.

Conclusion

Push-through endoscopicmyringoplasty is a less invasive technique of cartilage myringoplasty which has goodsuccess rate in terms of both graft uptake and hearing gain. The mean preoperative airbone gap of 26.46 dB was reduced to14.8 dB, with mean hearing improvement of 11.66dB. The technique achieved graft success rate of 92% with low complication profile.