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. 2024 Dec 27;39(4):268-274.
doi: 10.4274/MMJ.galenos.2024.88278.

Endoscopic Type 1 Tympanoplasty: Evaluation of Clinical Success and Hearing Improvement

Aynur Aliyeva  1 , Ramil Hashimli  2
Affiliations

Endoscopic Type 1 Tympanoplasty: Evaluation of Clinical Success and Hearing Improvement

Aynur Aliyeva et al. Medeni Med J. .

Abstract
in English, Turkish

Objective: This study aimed to assess the functional and clinical outcomes of endoscopic Type 1 tympanoplasty in patients with chronic otitis media and tympanic membrane perforations, focusing on hearing improvement and graft success rates.

Methods: This retrospective study included 46 patients with dry tympanic membrane perforations who underwent endoscopic Type 1 tympanoplasty. Audiometric data, including pure tone averages (PTA) and air-bone gap (ABG) measurements at four frequencies (500, 1000, 2000, and 4000 Hz), were collected preoperatively and postoperatively. Functional success was defined as a postoperative ABG of 20 dB, whereas the integrity of the graft determined clinical success.

Results: The mean preoperative ABG was 36.74±7.62 dB, which significantly improved to 15.05±3.82 dB postoperatively (p<0.001). The PTA exhibited an average gain of 28.17±6.87 dB for all frequencies. Functional success was achieved in 42 patients (91.30%), with 17 patients (36.96%) achieving normal hearing and 22 patients (47.83%) presenting with slight hearing loss postoperatively. Anatomical success was achieved in 42 patients (91.30%).

Conclusions: Endoscopic Type 1 tympanoplasty is a safe and effective surgical method for treating chronic otitis media, with high rates of both functional and clinical success, significant improvements in hearing outcomes, and minimal postoperative complications.

Amaç: Bu çalışma, kronik otitis media ve timpanik membran perforasyonu olan hastalarda endoskopik Tip 1 timpanoplastinin fonksiyonel ve klinik sonuçlarını, işitme iyileşmesi ve greft başarı oranlarına odaklanarak değerlendirmeyi amaçlamaktadır.

Yöntemler: Kuru timpanik membran perforasyonu bulunan 46 hastaya uygulanan endoskopik Tip 1 timpanoplastinin retrospektif analizi yapılmıştır. Saf ses ortalamaları (SSO) ve hava-kemik aralığı (HKA) ölçümleri de dahil olmak üzere dört frekansta (500, 1000, 2000 ve 4000 Hz) odyometrik veriler ameliyat öncesi ve sonrası toplanmıştır. Fonksiyonel başarı, ameliyat sonrası HKA’nin 20 dB’nin altında olması olarak tanımlanırken, klinik başarı greftin bütünlüğü ile değerlendirilmiştir.

Bulgular: Ameliyat öncesi ortalama HKA 36,74±7,62 dB iken, ameliyat sonrası bu değer anlamlı bir iyileşme göstererek 15.05±3.82 dB’ye düşmüştür (p<0,005). SSO’da tüm frekanslarda ortalama 28,17±6,87 dB kazanç sağlanmıştır. Fonksiyonel başarı 42 hastada (%91,30) elde edilmiş olup, 17 hasta (%36,96) normal işitmeye ulaşırken, 22 hasta (%47,83) ameliyat sonrası hafif işitme kaybı göstermiştir. Anatomik başarı, timpanik membran greftinin sağlam kalması ile belirlenmiş ve 42 hastada (%91,30) başarı elde edilmiştir.

Sonuçlar: Endoskopik Tip 1 timpanoplasti, kronik otitis media tedavisinde güvenli ve etkili bir cerrahi yöntem olup, yüksek oranda fonksiyonel ve klinik başarı, anlamlı işitme iyileşmeleri ve minimal postoperatif komplikasyonlar sağlamaktadır.

Keywords: Type 1 tympanoplasty; chronic otitis media; endoscopic approach; graft success; hearing improvement; tragal perichondrium graft.

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Conflict of interest statement

Conflict of Interest: The authors have no conflict of interest to declare.

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