Repair of Central and Marginal Perforations with Endoscopic Notched Thinned Tragal Chondroperichondrial Graft Myringoplasty in Adults

Background: Tympanic membrane perforation repair methods are available in a variety of types and can typically be categorised as underlay or overlay grafting methods. Each approach has a specific use, benefits, and challenges.
Objective: Evaluation of hearing level and closure of the tympanic membrane by the graft after endoscopic notched thinned tragal chondroperichondrial graft myringoplasty with no need to elevate the tympanomeatal flap for repair of central and marginal perforations.
Patients and Methods: A total of 30 participants with medium-sized central or marginal posterior perforations were included. done for them endoscopically assisted with notched thinned tragal chondroperichondrial myringoplasty was done for them. Measurements of hearing level and attachment rate of the graft after six months from the surgery, then again nine months later on.
Results: At six months, the take rate of the graft together with complete closure of the perforation was 96.7% (29/30), but after nine months, it was 93.3% (28/30). One patient experienced anterior annulus lateralization in addition to extrusion, and there was still evidence of perforation. 2 patients had acute otitis media at the same side of surgery resulting in a perforation. The mean preoperative gap between air and bone conduction (27.62 ± 3.15 dB) was more significant than the mean air-bone gap postoperatively (12.16 ± 3.01 dB; P < 0 .05) at six months. However, there was no statistically significant difference in the functional success rate (P 14.472), air-bone gap (ABG) levels (P 14.877), or ABG gain (P 14 0.748) between the post-6 months or post-9 months.
Conclusion: Endoscopic notched thinned chondroperichondrial graft myringoplasty with no need to elevate the myringomeatal flap is ideal for repairing central perforations. With minimally invasive technology. The long-term success rate of the graft is as high as the short-term success rate, and the hearing results are promising.