Endoscopic myringoplasty: outcome and hearing gain in inactive mucosal chronic otitis media


  • B. T. Subramanya Department of ENT, Subbaiah Institute of Medical Sciences, Shimoga, Karnataka, India
  • S. Lohith Department of ENT, Subbaiah Institute of Medical Sciences, Shimoga, Karnataka, India
  • B. Sphoorthi Department of ENT, Subbaiah Institute of Medical Sciences, Shimoga, Karnataka, India




Inactive mucosal chronic otitis media, Interlay, Endoscopic myringoplasty, Air bone gap, Graft uptake


Background: Chronic otitis media is an inflammatory process in the middle ear cleft that poses serious health problem in developing countries. Myringoplasty is a common otological procedure to reconstruct the tympanic membrane to prevent recurrent otorrhea, and restore sound-conducting mechanism. The use of rigid endoscope in transcanal myringoplasty has significant advantage as it provides magnified, close up as well as wide angle view, less morbidity and early postoperative wound healing with better cosmetic results without compromising success rate and postoperative hearing gain. The aims and objectives of the study were to analyze the results of endoscopic transcanal interlay myringoplasty, in terms of graft uptake and hearing improvement in cases of chronic suppurative otitis media with inactive mucosal disease with central perforation.

Methods: This is a prospective study conducted from January 2016 to August 2018 in 30 patients of inactive mucosal chronic otitis media (COM). All patients underwent transcanal endoscopic interlay myringoplasty and patients were called for regular follow up for 12 weeks and results were statistically analysed.  

Results: The graft uptake rate in the present study was found to be 93.33%. Pre operatively mean air bone gap (ABG) was 27.33 dB and post operatively after 12 weeks mean air bone gap improved to 10.5 dB. Mean ABG gain was 16.33%.

Conclusions: Endoscopic transcanal interlay myringoplasty with superiorly based TM flap is an effective technique over conventional microscopic technique in terms of graft uptake, hearing improvement, better postoperative scar and less morbidity in cases of inactive mucosal COM.


Kawatra R, Maheshwari P, Kumar G. A comparative study of the techniques of myringoplasty – Overlay, underlay & interlay. IOSR J Dent Med Sci. 2014;13:12-6.

Rourke T, Snelling JD, Aldren C. Cartilage graft butterfly myringoplasty: how we do it. Clin Otolaryngol. 2010;35:135-8.

Hosny S, El-Anwar MW, Abd-Elhady M, Khazbak A, El Feky A. Outcomes of Myringoplasty in Wet and Dry Ears. Int Adv Otol. 2014;10(3):256-9.

Dennis SP. Endoscopic assisted middle ear surgery In: Glasscock ME III, Gulya AJ, editors. Surgery of the ear. 5th ed. Hamilton: Elsevier; 2003: 325-334.

El Guidy A. Endoscopic transcanal myringoplasty. J Laryngol Otol. 1992;106:493-5.

Shoeb M, Gite V, Bhargava S, Mhashal S. Comparison of surgical outcomes of tympanoplasty assisted by conventional microscopic method and endoscopic method. Int J Otorhinolaryngol Head Neck Surg. 2016;2(4):184-8.

Karhuketo TS, Ilomäki JH, Puhakka HJ.Tympanoscope-Assisted Myringoplasty. ORL. 2001;63:353-8.

Furukawa T, Watanabe T, Ito T, Kubota T, Kakehata S. Feasibility and advantages of transcanal endoscopic myringoplasty. Otol Neurotol. 2014;35(4):140-5.

Raj A, Mehr R, Endoscopic transcanal myringoplasty- A study. Indian J Otol. 2001;53(1):47-9.

Ghaffar S, Ikram M, Zia S, Raza A. Incorporating the endoscope into middle ear surgery. Ear Nose Throat J. 2006;85(9):593-6.

Ambani KP, Bhavya BM, VakhariaSD, Khanna A, Katarkar AU. Merits and demerits of endoscopic tympanoplasty. Int J Otorhinolaryngol HeadNeck Surg. 2017;3(2):395-9.

Gaur RS, Tejavath P, Chandel S. Comparative study of microscopic-assisted and endoscopic-assisted myringoplasty. Indian J Otol 2016;22(3):177-82.

Komune S, Wakizono S, Hisashi K, Uemura T. Interlay method for myringoplasty. Auris Nasus Larynx. 1992;19(1):17-22.

Hay A, Blanshard J. The anterior interlay myringoplasty: Outcome and hearing results in anterior and subtotal tympanic membrane perforations.Otol Neurotol. 2014;35(9):1569-76.

Jain S, Gupta N, Gupta R, Roy A. Interlay Type I tympanoplasty in large central perforations: Analysis of 500 cases. Indian J Otol. 2017;23:32-5.

Patil BC, Misale PR, Mane RS, Mohite AA. Outcome of interlaygrafting in type 1 tympanoplasty for large central perforation. Indian JOtolaryngol Head Neck Surg. 2014;66:418-24.

Yadav SPS, Aggarwal N, Julaha M, Goel A. Endoscope -assisted myringoplasty. Singapore Med J. 2009;50(5):510.

Choi N, Noh Y, Park W, Lee JJ, Yook S, Choi JE et al. Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty. Clin Exp Otorhinolaryngol. 2017;10(1):44-9.

Kumar M, Kanaujia SK, Singh A. A comparative study of endoscopic vs conventional myringoplasty. Int J Otolaryngol Clin. 2015;7(3):132-7.






Original Research Articles