Comparison of transcanal endoscopic tympanoplasty with sterile acellular dermal allograft to conventional endaural microscopic tympanoplasty with tragal perichondrium

Objectives: This study aimed to compare the outcome of endoscopic tympanoplasty with sterile acellular dermal allograft (ADA) and conventional endaural microscopic tympanoplasty with tragal perichondrium.& para;& para;Methods: This was a retrospective comparative study of 53 patients (25 males and 28 females) with tympanic membrane perforation who underwent type I tympanoplasty in the department of otorhinolaryngology at a tertiary medical center from March 2011 to April 2017. The subjects were classified into two groups; transcanal endoscopic tympanoplasty with ADA (TET, n = 26), conventional endaural microscopic tympanoplasty with autologous tragal perichondrium (EMT, n = 27). Demographic data, perforation size of tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3 months postoperatively, operation time, sequential postoperative pain scale, and postoperative graft failure rate were evaluated.& para;& para;Results: The perforation size of the tympanic membrane in TET and EMT group was 22.3 +/- 10.9% and 23.5 +/- 9.7%. respectively (P = 0.143). Mean operation time of EMT (92.3 +/- 16.5 min) was longer than that of the TET (65.3 +/- 20.5 min) with a statistical significance (P = 0.004). Graft success rate in the TET and EMT group were 92.3% and 96.3%, respectively; the values were not significantly different (P = 0.610). Pre- and postoperative audiometric results including bone and air conduction thresholds and air-bone gap were not significantly different between the groups. In all groups, the postoperative air-bone gap was significantly improved compared to the preoperative air-bone gap. Pain in the immediate postoperative and day 1 after surgery were significantly less in the TET group.& para;& para;Conclusion: With human cadaveric ADA, minimal invasive endoscopic tympanoplasty can be achieved with similar postoperative results and less pain. (C) 2017 Elsevier Inc. All rights reserved.