Hostname: page-component-6766d58669-rxg44 Total loading time: 0 Render date: 2026-05-16T02:34:29.138Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of endoscopic type I tympanoplasty/myringoplasty with or without tympanomeatal flap elevation for tympanic membrane repair: a systematic review and meta-analysis

Published online by Cambridge University Press:  25 April 2025

Danyang Chang ,
Qian Cao ,
Bingyi Dai  and
Changling Sun Open the ORCID record for Changling Sun [Opens in a new window]
Bingyi Dai
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jiangnan University, Wuxi, JS, China
Changling Sun*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jiangnan University, Wuxi, JS, China
*
Corresponding author: Changling Sun; Email: winterc126@sina.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

This study aimed to compare the efficacy of endoscopic type I tympanoplasty/myringoplasty with (ETMFE) or without tympanomeatal flap elevation (ETMFNE).

Methods

A thorough search of the PubMed, Embase and Cochrane Library databases was executed. The Review Manager 5.4 software was used for synthesising data, with forest plots illustrating the results for each outcome. Assessment of potential publication bias was conducted using funnel plots and Egger’s test.

Results

The meta-analysis included data from seven studies with 839 patients. The results demonstrated no significant difference in graft success rates (risk ratio = 1.01; 95 per cent confidence interval: 0.98–1.04; p = 0.54) or air–bone gap improvement (mean difference = –0.08; 95 per cent confidence interval: –2.02–1.85; p = 0.93) between the ETMFE and ETMFNE groups. However, the ETMFE group showed a pronounced increase in operation time (mean difference = 19.50; 95 per cent confidence interval: 10.75–28.25; p < 0.0001).

Conclusion

ETMFNE could be a preferable option for tympanic membrane perforation, offering similar efficacy to ETMFE but with reduced surgical time, particularly in appropriately selected cases.

Keywords

endoscopymiddle ear surgeryotitis mediasystematic reviews

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 9 , September 2025 , pp. 767 - 773
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Changling Sun takes responsibility for the integrity of the content of the paper

#

These authors contributed equally to this study

References

Lee, S-Y, Lee, DY, Seo, Y, Kim, YH. Can endoscopic tympanoplasty be a good alternative to microscopic tympanoplasty? A systematic review and meta-analysis. Clin Exp Otorhinolaryngol 2019;12:145–55CrossRefGoogle ScholarPubMed
Tseng, C-C, Lai, M-T, Wu, C-C, Yuan, S-P, Ding, Y-F. Endoscopic transcanal myringoplasty for anterior perforations of the tympanic membrane. JAMA Otolaryngol Head Neck Surg 2016;142:1088–93CrossRefGoogle ScholarPubMed
Chen, Y, Jiang, X, Yang, L, Wang, J, Li, P. Endoscopic transcanal push-trough myringoplasty for different types of tympanic membrane perforations. Otol Neurotol 2021;42:726–32CrossRefGoogle ScholarPubMed
Schwam, ZG, Cosetti, MK. Endoscopic myringoplasty and type I tympanoplasty. Otolaryngol Clin North Am 2021;54:75–88CrossRefGoogle ScholarPubMed
Furukawa, T, Watanabe, T, Ito, T, Kubota, T, Kakehata, S. Feasibility and advantages of transcanal endoscopic myringoplasty. Otol Neurotol 2014;35:e140–5CrossRefGoogle ScholarPubMed
Marchioni, D, Gazzini, L, De Rossi, S, Di Maro, F, Sacchetto, L, Carner, M, et al. The management of tympanic membrane perforation with endoscopic type I tympanoplasty. Otol Neurotol 2020;41:214–21CrossRefGoogle ScholarPubMed
Fermi, M, Maccarrone, F, Villari, D, Palermo, F, Alicandri-Ciufelli, M, Ghirelli, M, et al. Endoscopic tympanoplasty type I for tympanic perforations: analysis of prognostic factors. Eur Arch Otorhinolaryngol 2021;278:4715–22CrossRefGoogle ScholarPubMed
Tseng, C-C, Lai, M-T, Wu, C-C, Yuan, S-P, Ding, Y-F. Comparison of endoscopic transcanal myringoplasty and endoscopic type I tympanoplasty in repairing medium-sized tympanic perforations. Auris Nasus Larynx 2017;44:672–7CrossRefGoogle ScholarPubMed
Wang, D, Wang, W. The outcomes of endoscopic myringoplasty: elevating a tympanomeatal flap or not. J Laryngol Otol 2020;1–5Google ScholarPubMed
Ko, C-A, Yang, C-H, Wu, C-N, Huang, P, Hwang, C-F. Comparison of the functional success of fat myringoplasty and perifascial areolar tympanoplasty in transcanal endoscopic ear surgery. Ear Nose Throat J 2022;101:314–8CrossRefGoogle ScholarPubMed
Lou, Z. Endoscopic myringoplasty in pediatric patients: a comparison of cartilage graft push-through and underlay fascia graft techniques. Acta Otolaryngol 2020;140:893–8CrossRefGoogle ScholarPubMed
Atchariyasathian, V, Suwannajak, R, Plodpai, Y, Pitathawatchai, P. A comparison of endoscopic transtympanic myringoplasty and endoscopic type I tympanoplasty for repairing medium- to large-sized tympanic membrane perforation: a randomized clinical trial. Eur Arch Otorhinolaryngol 2020;277:2199–207CrossRefGoogle ScholarPubMed
Sun, J. Comparison of perichondrium-cartilage button technique and traditional over-underlay technique for repairing large perforations. J Laryngol Otol 2024;138:148–52CrossRefGoogle ScholarPubMed
Chen, C-K, Kuo, C-L, Weng, Y-T, Hsieh, L-C. Endoscopic transcanal transtympanic myringoplasty vs. endoscopic transcanal tympanoplasty: 1-year follow-up study. J Chin Med Assoc 2022;85:1017–23CrossRefGoogle ScholarPubMed
Oxford Centre for Evidence-based Medicine–Levels of Evidence. 2009. In: https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009 [20 July 2024]Google Scholar
Jadad, AR, Moore, RA, Carroll, D, Jenkinson, C, Reynolds, DJ, Gavaghan, DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1–12CrossRefGoogle ScholarPubMed
Slim, K, Nini, E, Forestier, D, Kwiatkowski, F, Panis, Y, Chipponi, J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 2003;73:712–16CrossRefGoogle ScholarPubMed
Akyigit, A, Sakallıoglu, O, Karlidag, T. Endoscopic tympanoplasty. J Otol 2017;12:62–7CrossRefGoogle ScholarPubMed
Schwam, ZG, Cosetti, MK. Endoscopic myringoplasty and type I tympanoplasty. Otolaryngol Clin North Am 2021;54:75–88CrossRefGoogle ScholarPubMed
Doğan, S, Bayraktar, C. Endoscopic tympanoplasty: learning curve for a surgeon already trained in microscopic tympanoplasty. Eur Arch Otorhinolaryngol 2017;274:1853–8CrossRefGoogle ScholarPubMed
Nicholas, Jungbauer W Jr, Jeong, S, Nguyen, SA, and Lambert, PR. Comparing myringoplasty to type I tympanoplasty in tympanic membrane repair: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2023;168:922–34CrossRefGoogle Scholar