Minimally invasive transcanal endoscopic tympanoplasty: our experience in 120 cases of mucosal chronic suppurative otitis media

Background: Endoscopic procedures began the era of minimally invasive surgery in otorhinolaryngology. Even in patients with a narrow external canal, the endoscopic technique facilitates easier transcanal tympanoplasty. Methods: We conducted a retrospective study for evaluation of 120 patients who underwent endoscopic transcanal tympanoplasty between 2020 and 2023. Tragal cartilage was used as graft material. Patients were assessed for graft success rate, and hearing outcomes, duration of surgery, length of hospital stay, postoperative morbidity. Results: The overall graft uptake rate was 96.6% (116 patients). The average duration of surgery was 45.60±17.39 minutes. Endoscopic transcanal tympanoplasty yielded excellent cosmetic results in all cases. The mean pure tone audiometry (PTA) before surgery was 32.4±7.5 dB, while the mean PTA at 24 weeks post-surgery was 25.6±6.8 dB, with a statistically significant p value of 0.001. Additionally, a significant closure of the air-bone gap (ABG) was observed postoperatively. The average hospital stay was 1.05±0.15 days. Conclusions: Endoscopic tympanoplasty provides broad visibility and ease of application for middle ear surgery, with a short operating time, reduced risk of complications, and a minimally invasive approach but long learning curve associated with this technique.