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Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane perforations

  • D E M El-Hennawi (a1), M R Ahmed (a1), A S Abou-Halawa (a1) and M A Al-Hamtary (a1)



Microscopic myringoplasty is the most frequently performed procedure for repairing tympanic membrane perforations. The endoscopic transcanal approach bypasses the narrow ear canal segment and provides a wider view.


An open-label randomised clinical trial was conducted on 56 patients with small anterior tympanic membrane perforations. Perforations were repaired with an endoscopic push-through technique (n = 28) or a microscopic underlay technique (n = 28). Follow up was conducted using endoscopic examination and pure tone audiometry three months’ post-operatively.


Graft success rate was 92.9 per cent in the endoscopic group versus 85.7 per cent in the microscopic group. The corresponding pre-operative mean air–bone gaps were 17.4 dB and 18.5 dB, improving to 6.1 dB and 9.3 dB post-operatively (p > 0.05). Mean air–bone gap closure was 11.4 dB in the endoscopic group and 9.2 dB in the microscopic group (p > 0.05). Mean operative time and estimated blood loss were 37.0 minutes and 29 ml in the endoscopic group, versus 107 minutes and 153 ml in the microscopic group (both p < 0.05).


The endoscopic push-through technique for anterior tympanic membrane perforations is as effective as microscopic underlay myringoplasty; furthermore, it is less invasive and takes less operative time.


Corresponding author

Author for correspondence: Dr Mohammed Rifaat Ahmed, Otolaryngology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt E-mail: Fax: +20 663 415 603


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Dr M R Ahmed takes responsibility for the integrity of the content of the paper



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Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane perforations

  • D E M El-Hennawi (a1), M R Ahmed (a1), A S Abou-Halawa (a1) and M A Al-Hamtary (a1)


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