Prospective study of Outcome of Endoscopic Transcanal Myringoplasty Using 0* Nasal Endoscope

Mahan Raj, A (2013) Prospective study of Outcome of Endoscopic Transcanal Myringoplasty Using 0* Nasal Endoscope. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: The endoscope is an equipment used successfully in several procedures of several medical specialities. Since the advent of endoscope, the management and understanding of rhinological disorders has undergone a revolutionary change. Over the past few years now the endoscope has been used increasingly for otological inspection and surgery. Endoscopic or endoscope assisted myringoplasty is being performed increasingly by various surgeons for the past 10-15 years. Myringoplasty is one of the commonest operations performed on the middle ear. Over the last hundred years continued efforts have been made by otologists all over the world to attain perfect surgical outcome. Traditionally over the decades myringoplasty has been done using an operating microscope. Despite the continuous technical advancements, the basic optical principles of the microscope and their limitations have remained the same over the last three decades. Middle ear endoscopy was first introduced by Mer and colleagues in 1967 but till the last decade endoscopes have been mainly used for diagnostic and photographic purposes. AIM OF THE STUDY: 1. To evaluate the advantage of using 0* nasal endoscope for transcanal myringoplasty. 2. To create awareness of the various surgical procedures. 3. Improved compliance of the technique preferred / decreased incidence of recurrence. MATERIALS AND METHODS: Study Design: Prospective Study Period: JULY 2011 TO OCTOBER 2012 Sample Size: 100 INCLUSION CRITERIA: • 15-40 years of age both sexes. • Patients with small,medium and subtotal central perforation. • Usage of temporalis fascia graft only. • Only underlay technique myringoplasty with no ossicular reconstruction. • No evidence of active infection in nose, throat and paranasal sinuses. EXCLUSION CRITERIA: • Patients with total and attic perforation. • Patients with sensorineural hearing loss. • Revision cases. • Patients under 15 years. CONCLUSION: The wide angled, magnified and having a telescopic view of the 0* rigid nasal endoscopes certainly has a role in transcanal approach in myringoplasty. The graft uptake rate were 88% and hearing improvement was 85%. The endoscopic transcanal technique provides good results in terms of post-operative recovery and cosmesis. Since it’s a portable device the endoscope can be carried to remote places for surgical procedure. One handed technique and limited depth perception are some of the limitations of this procedure and with practice it can be easily overcome. Sex or age does not have a significant role in the outcome of the procedure. The overall graft uptake and hearing improvement were better in medium sized perforations indicating that perforation size does have some role in the results of the procedure. The conclusion we draw from the conducted study is that for myringoplasty through transcanal route the 0* nasal endoscope can be used successfully with a reasonable success rate both in terms of hearing improvement and closure of the perforation with very minimal exposure.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Endoscopic Transcanal Myringoplasty, 0* Nasal Endoscope, Prospective study.
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 27 Mar 2020 05:08
Last Modified: 27 Mar 2020 05:08

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