Tympanic Membrane Perforation Clinical Trial
Official title:
Endoscopic Overlay Tympanoplasty in Correcting Large Tympanic Membrane Perforation
Minimally invasive surgery is becoming more common in many surgical fields. The wide view of endoscope allows for minimally invasive transcanal approach instead of large postauricular opening. The investigators conduct this study to compared post operative pain score (by Visual Analogue Scales) between conventional microscope lateral placing tympanoplasty and endoscopic lateral placing tympanoplasty.
A main part of tympanoplasty is repair of perforated tympanic membrane. There are two popular
way to approach tympanic membrane, transcanal or postauricular approach. There are two
grafting techniques are applied in tympanoplasty which includes the lateral technique
(overlay) and medial technique (underlay).
The lateral technique is widely used in our institute which involves placement of a graft
lateral to the tympanic annulus and the fibrous layer of the tympanic remnant. The most our
preferred approach in previous experience is the postauricular approach for tympanoplasty
because the transcanal approach is not enough for adequate exposure. Moreover, the
visualization straight through transcanal provide by the microscope is difficult by a limited
view of the perforation edge due to narrowing and curved external ear canal. Postauricular
approach cause many layers of tissue are violated along with a significant postoperative
pain.
The author proposed this study with the aim of determining the alleviation of postoperative
pain by new technique and the efficacy of endoscope for tympanoplasty.
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