{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:41:03Z","timestamp":1773052863747,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T00:00:00Z","timestamp":1489708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To review experience from the introduction of totally endoscopic ear surgery (TEES) to a pediatric tympanoplasty practice to identify factors influencing technique selection and successful outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analysis of prospectively acquired data from a consecutive series of 295 surgeries for tympanic membrane perforation over a 12\u2010year period. Success of perforation closure was compared between microscope and TEES grafting techniques. Impact of the acquisition of endoscopic techniques and equipment were compared with annual proportion of cases completed by TEES.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 267 tympanoplasties, 109 (41%) were completed with TEES and 158 by a postauricular approach. The proportion completed with TEES increased gradually to 97% of cases as equipment and expertise were acquired. Young age did not prevent TEES tympanoplasty. Two hundred nineteen of 250 (88%) perforations were closed successfully by tympanoplasty, with equivalent closure rates between TEES and postauricular approaches. Underlay of tragal perichondrium was less successful than lateral graft technique using TEES (<jats:italic>P<\/jats:italic> = .04, Fisher exact test). \u201cPush\u2010through\u201d myringoplasty using a microscope or endoscope was least successful (19 of 28 (68%), <jats:italic>P<\/jats:italic> = .005). The median length of stay was 13 hours shorter for TEES than postauricular tympanoplasty (<jats:italic>P<\/jats:italic> = .04, Mann\u2010Whitney rank sum test). Wound complications occurred in five (3%) postauricular cases and one TEES case.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TEES tympanoplasty is feasible in a large majority of children given appropriate equipment and surgical experience. Nonautogenous graft material is ideal for this minimally invasive approach. TEES is recommended as providing equivalent likelihood of perforation closure to the post\u2010auricular approach but with less postoperative morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2b. <jats:italic>Laryngoscope<\/jats:italic>, 127:2659\u20132664, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26568","type":"journal-article","created":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T09:46:53Z","timestamp":1489744013000},"page":"2659-2664","source":"Crossref","is-referenced-by-count":66,"title":["Endoscope or microscope\u2010guided pediatric tympanoplasty? Comparison of grafting technique and outcome"],"prefix":"10.1002","volume":"127","author":[{"given":"Adrian L.","family":"James","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto, Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0117-7"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200209000-00004"},{"key":"e_1_2_7_4_1","first-page":"153","article-title":"Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review","volume":"34","author":"Presutti L","year":"2014","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_7_5_1","first-page":"564","article-title":"Endoscopic ear surgery. Initial evaluation [in French]","volume":"107","author":"Thomassin JM","year":"1990","journal-title":"Ann Otolaryngol Chir Cervicofac"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949910800106"},{"issue":"6","key":"e_1_2_7_7_1","first-page":"48","article-title":"Advantages and disadvantages of the application of endoscopic techniques at different stages of tympanoplasty [in Russian]","author":"Semenov FV","year":"2010","journal-title":"Vestnik Otorinolaringologii"},{"key":"e_1_2_7_8_1","first-page":"510","article-title":"Endoscope\u2010assisted myringoplasty","volume":"50","author":"Yadav SP","year":"2009","journal-title":"Singapore Med J"},{"key":"e_1_2_7_9_1","unstructured":"NogeiraJF.Courses and meetings with endoscopic ear surgery. International Working Group on Endoscopic Ear Surgery website. Available at:http:\/\/www.iwgees.org. Accessed November2016."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25410"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.08.025"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.10.019"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2012.10.007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199805000-00006"},{"key":"e_1_2_7_15_1","first-page":"196","article-title":"Experience with the quilt\u2010plasty in tympanoplastic operations (author's transl) [in German]","volume":"54","author":"Gerlach H","year":"1975","journal-title":"Laryngol Rhinol Otol (Stuttg)"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221510011847X"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2006.02.012"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812460497"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0385-8146(12)80197-0"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25048"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000767"},{"key":"e_1_2_7_22_1","first-page":"95","article-title":"The tragus as a donor area of cartilage grafts: anatomic study [in Portuguese]","volume":"42","author":"Ishida LC","year":"1996","journal-title":"Rev Assoc Med Bras (1992)"},{"key":"e_1_2_7_23_1","first-page":"1","article-title":"The postnatal growth of the temporal bone and its implications for cochlear implantation in children","volume":"505","author":"Dahm MC","year":"1993","journal-title":"Acta Otolaryngol Suppl"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-013-0097-1"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.12.017"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.125.5.530"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.04.037"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000172042.73024.ad"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016488309132899"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2008.07.012"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196211000-00003"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000512"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.26568","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.26568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T03:59:59Z","timestamp":1696046399000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.26568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,17]]},"references-count":31,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1002\/lary.26568"],"URL":"https:\/\/doi.org\/10.1002\/lary.26568","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,17]]}}}