Efficacy of Endoscopic Push-Through Perichondrial Myringoplasty Without Tympanomeatal Flap Elevation

Background and Objectives Endoscopic ear surgery has gained widespread application in otology as a minimally invasive surgical technique that minimizes patient morbidity. This study aimed to evaluate the surgical and audiological outcomes of endoscopic push-through perichondrial myringoplasty (EPPM) without tympanomeatal flap elevation. Subjects and Method We retrospectively reviewed the medical records of 34 patients with chronic otitis media who underwent EPPM without tympanomeatal flap elevation between July 2018 and January 2023. The primary outcomes, including graft success rate, audiological outcomes, and surgical complications, were evaluated. Results Among the 34 patients, 22 were female and 12 were male. The mean age was 58.0± 16.1 (18-83) years and the mean follow-up period was 15.7±10.4 (4-45) months. The overall graft success rate was 91.2% (31/34). The mean preoperative and postoperative air-bone gaps (ABG) were 15.5±11.6 dB and 6.9±6.7 dB, respectively. The mean postoperative ABG significantly improved compared to the mean preoperative ABG (p<0.001). A postoperative ABG ≤20 dB, indicating successful hearing outcomes, was achieved in 92.3% (24/26) of the patients. No major intra- or postoperative complications were observed. Conclusion This study revealed that EPPM without tympanomeatal flap elevation is an effective surgical technique and that it provided favorable surgical and audiological outcomes in patients with chronic otitis media.