ENDOSCOPIC EAR SURGERY IN CROATIA - INITIAL RESULTS OF TOTAL ENDOSCOPIC TRANSCANAL MYRINGOPLASTY/ENDOSKOPSKA KIRURGIJA UHA U HRVATSKOJ - PRVI REZULTATI POTPUNO ENDOSKOPSKIH TRANSMEATALNIH MIRINGOPLASTIKA

The aim of this study was to show clinical outcome in 56 patients with tympanic membrane perforation operated on by total endoscopic transcanal myringoplasty. Out of the total of 74 patients operated on exclusively endoscopically, we identified 56 patients in whom tympanoplasty type I (myringoplasty) was performed. In 43 patients (45 ears), myringoplasty was performed in a standard transcanal fashion with lifting of the tympanomeatal flap, and in 13 patient butterfly myringoplasty was performed. The size and position of perforation, surgery duration, hearing status and closure of the perforation were evaluated. Perforation closure was obtained in 50 of 58 ears (86.21%). The mean surgery duration was 62.69[+ or -]22.56 minutes in both groups. Hearing improved significantly, with the preoperative mean air-bone gap of 20.41[+ or -]9.29 dB improving to the postoperative mean air-bone gap of 9.05[+ or -]7.77 dB. No major complications were recorded. Our results of graft success rate and hearing outcomes are comparable with those of microscopic myringoplasties but without the need for external incisions and with reduced surgical morbidity. Hence, we recommend total endoscopic transcanal myringoplasty as the method of choice for tympanic membrane perforation regardless of its size and location. Key words: Type 1 tympanoplasty; Endoscopic ear surgery; Endoscopic myringoplasty; Tympanic membrane perforation; Chronic otitis media Cilj ovoga rada je prikazati na?e dosada?nje rezultate potpuno endoskopskih transmeatalnih miringoplastika. Provedena je retrospektivna analiza baze podataka bolesnika operiranih endoskopskim putem. Od ukupno 74 operiranih bolesnika u studiju je ukljuceno 56 bolesnika (58 u?iju) kod kojih je radena timpanoplastika tip I. (miringoplastika) s minimalnim trajanjem pracenja od 3 mjeseca nakon operacije. Kod 43 bolesnika (45 u?iju) operacija je izvedena standardnim odizanjem timpanomeatalnog re?nja, dok je kod 13 bolesnika operacija ucinjena bez odizanja re?nja, tzv. tehnikom butterfly. Pratili smo velicinu i poziciju perforacije prijeoperacijski, trajanje same operacije, pobolj?anje sluha te uspje?nost zatvaranja perforacije. Ukupno je uspje?nost zatvaranja perforacije bila 86,21% (50 od 58 uha). Prosjecno je operacija trajala 62,69[+ or -]22,56 minuta. Znacajno pobolj?anje postignuto je u kvaliteti sluha koja se pobolj?ala s 20,41[+ or -]9,29 dB razlike u zracno-ko?tanoj vodljivosti prijeoperacijski na 9,05[+ or -]7,77 dB razlike poslijeoperac