{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T20:10:11Z","timestamp":1756671011558,"version":"3.44.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Health Sciences"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>A new endoscopic tympanoplasty technique for large and medium-sized central perforations via a transcanal approach, without tympanomeatal flap elevation compared the preliminary postoperative graft success and hearing outcomes with other techniques in the literature.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The study involved 75 patients aged 12 to 44 who underwent tympanoplasty with the lateral malleolar flap technique from 2014 to 2017. Pre-operative otoscopy recorded perforation sizes, and pure tone averages were calculated at 500, 1000, 2000, and 4000\u00a0Hz. The procedure was performed under general anesthesia via a transcanal approach using tragal cartilage, without tympanomeatal flap elevation. A control otoscopy was conducted six months post-operation to assess reperforation and graft position. Pure tone averages were measured, and pre-operative and post-operative audiological values were compared.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Post-operative six-month graft success rate was 94.6%. Reperforation was observed in one patient (1.3%), while another patient (1.3%) exhibited lateralization, and two patients (2.6%) demonstrated medialization. The pre-operative mean hearing level was recorded at 33.3\u2009\u00b1\u20097.0 dB, accompanied by an Air-Bone Gap (ABG) of 24.0\u2009\u00b1\u20096.6 dB. Post-operative measurements indicated an improvement in these values, with the mean hearing level decreasing to 18.0\u2009\u00b1\u20094.8 dB and the ABG reducing to 16.3\u2009\u00b1\u20095.3 dB (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The endoscopic underlay cartilage tympanoplasty with lateral malleolar flap is a safe technique that avoids elevating the tympanomeatal flap. It offers shorter operation time, easier postoperative dressing, and high graft success rates similar to other tympanoplasty techniques.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00405-025-09337-5","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T06:52:40Z","timestamp":1743403960000},"page":"4041-4048","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preliminary results of a new endoscopic underlay cartilage tympanoplasty with lateral malleolar flap"],"prefix":"10.1007","volume":"282","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-8437","authenticated-orcid":false,"given":"Pinar","family":"Atabey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4157-3396","authenticated-orcid":false,"given":"Burcu Vural","family":"Camalan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-2738","authenticated-orcid":false,"given":"Hasan","family":"Demirel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0999-457X","authenticated-orcid":false,"given":"Mehmet Beyhan","family":"Balur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7264-6578","authenticated-orcid":false,"given":"Sumeyra","family":"Doluoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"9337_CR1","unstructured":"Morris P (2012) Chronic suppurative otitis media. BMJ Clin Evid. 2012:0507. PMID: 23870746"},{"issue":"2","key":"9337_CR2","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/s1808-8694(15)30067-7","volume":"72","author":"I Fukuchi","year":"2006","unstructured":"Fukuchi I, Cerchiari DP, Garcia E, Rezende CE, Rapoport PB (2006) Tympanoplasty: surgical results and a comparison of the factors that May interfere in their success. Braz J Otorhinolaryngol 72(2):267\u2013271. https:\/\/doi.org\/10.1016\/s1808-8694(15)30067-7","journal-title":"Braz J Otorhinolaryngol"},{"issue":"6","key":"9337_CR3","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1111\/coa.13407","volume":"44","author":"I Pap","year":"2019","unstructured":"Pap I, T\u00f3th I, Gede N, Hegyi P, Szak\u00e1cs Z, Koukkoullis A, R\u00e9v\u00e9sz P, Harmat K, N\u00e9meth A, Lujber L, Gerlinger I, Bocskai T, Varga G, Szanyi I (2019) Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive-A meta-analysis. Clin Otolaryngol 44(6):942\u2013953. https:\/\/doi.org\/10.1111\/coa.13407","journal-title":"Clin Otolaryngol"},{"issue":"4","key":"9337_CR4","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1067\/mhn.2000.105994","volume":"123","author":"JF Lubianca-Neto","year":"2000","unstructured":"Lubianca-Neto JF (2000) Inlay butterfly cartilage tympanoplasty (Eavey technique) modified for adults. Otolaryngol Head Neck Surg 123(4):492\u2013494. https:\/\/doi.org\/10.1067\/mhn.2000.105994","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"5","key":"9337_CR5","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1097\/00005537-200205000-00007","volume":"112","author":"JM Kartush","year":"2002","unstructured":"Kartush JM, Michaelides EM, Becvarovski Z, LaRouere MJ (2002) Over-under tympanoplasty. Laryngoscope 112(5):802\u2013807. https:\/\/doi.org\/10.1097\/00005537-200205000-00007","journal-title":"Laryngoscope"},{"issue":"9\u201310","key":"9337_CR6","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1111\/jocn.13456","volume":"26","author":"T Sibbern","year":"2017","unstructured":"Sibbern T, Bull Sellevold V, Steindal SA, Dale C, Watt-Watson J, Dihle A (2017) Patients\u2019 experiences of enhanced recovery after surgery: a systematic review of qualitative studies. J Clin Nurs 26(9\u201310):1172\u20131188. https:\/\/doi.org\/10.1111\/jocn.13456","journal-title":"J Clin Nurs"},{"issue":"1","key":"9337_CR7","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1089\/jmxr.2024.0010","volume":"1","author":"M Aweeda","year":"2024","unstructured":"Aweeda M, Adegboye F, Yang SF, Topf MC (2024) Enhancing surgical vision: augmented reality in Otolaryngology-Head and neck surgery. J Med Ext Real 1(1):124\u2013136. https:\/\/doi.org\/10.1089\/jmxr.2024.0010","journal-title":"J Med Ext Real"},{"issue":"5","key":"9337_CR8","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1002\/ohn.191","volume":"168","author":"W Nicholas Jungbauer Jr","year":"2023","unstructured":"Nicholas Jungbauer W Jr, Jeong S, Nguyen SA, Lambert PR (2023) Comparing Myringoplasty to type I tympanoplasty in tympanic membrane repair: A systematic review and Meta-analysis. Otolaryngol Head Neck Surg 168(5):922\u2013934. https:\/\/doi.org\/10.1002\/ohn.191","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"9","key":"9337_CR9","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1097\/01.mlg.0000175067.19744.27","volume":"115","author":"S Schraff","year":"2005","unstructured":"Schraff S, Dash N, Strasnick B (2005) Window shade tympanoplasty for anterior marginal perforations. Laryngoscope 115(9):1655\u20131659. https:\/\/doi.org\/10.1097\/01.mlg.0000175067.19744.27","journal-title":"Laryngoscope"},{"issue":"5","key":"9337_CR10","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1097\/00005537-199805000-00006","volume":"108","author":"RD Eavey","year":"1998","unstructured":"Eavey RD (1998) Inlay tympanoplasty: cartilage butterfly technique. Laryngoscope 108(5):657\u2013661. https:\/\/doi.org\/10.1097\/00005537-199805000-00006","journal-title":"Laryngoscope"},{"issue":"6","key":"9337_CR11","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1258\/002221503321892262","volume":"117","author":"M Singh","year":"2003","unstructured":"Singh M, Rai A, Bandyopadhyay S, Gupta SC (2003) Comparative study of the underlay and overlay techniques of Myringoplasty in large and subtotal perforations of the tympanic membrane. J Laryngol Otol 117(6):444\u2013448. https:\/\/doi.org\/10.1258\/002221503321892262","journal-title":"J Laryngol Otol"},{"issue":"10","key":"9337_CR12","doi-asserted-by":"publisher","first-page":"2169","DOI":"10.1007\/s00405-011-1875-5","volume":"269","author":"X Altuna","year":"2012","unstructured":"Altuna X, Navarro JJ, Algaba J (2012) Island cartilage tympanoplasty in revision cases: anatomic and functional results. Eur Arch Otorhinolaryngol 269(10):2169\u20132172. https:\/\/doi.org\/10.1007\/s00405-011-1875-5","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"4","key":"9337_CR13","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.bjorl.2019.06.014","volume":"86","author":"K \u00d6zdamar","year":"2020","unstructured":"\u00d6zdamar K, Sen A (2020) Comparison of Temporal muscle fascia and Tragal cartilage perichondrium in endoscopic type 1 tympanoplasty with limited elevation of tympanomeatal flap. Braz J Otorhinolaryngol 86(4):483\u2013489. https:\/\/doi.org\/10.1016\/j.bjorl.2019.06.014","journal-title":"Braz J Otorhinolaryngol"},{"issue":"4","key":"9337_CR14","first-page":"295","volume":"40","author":"K Onal","year":"2011","unstructured":"Onal K, Arslanoglu S, Oncel S, Songu M, Kopar A, Demiray U (2011) Perichondrium\/ cartilage Island flap and temporalis muscle fascia in type I tympanoplasty. J Otolaryngol Head Neck Surg 40(4):295\u2013299 PMID: 21777547","journal-title":"J Otolaryngol Head Neck Surg"},{"issue":"1","key":"9337_CR15","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1159\/000335056","volume":"74","author":"K Bozdemir","year":"2012","unstructured":"Bozdemir K, Kutluhan A, Yal\u00e7\u0131ner G, Tarlak B, Bilgen AS (2012) Tympanoplasty with Island cartilage or temporalis fascia: a comparative study. ORL J Otorhinolaryngol Relat Spec 74(1):28\u201332. https:\/\/doi.org\/10.1159\/000335056","journal-title":"ORL J Otorhinolaryngol Relat Spec"},{"issue":"6","key":"9337_CR16","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.otohns.2005.01.044","volume":"132","author":"T Kirazli","year":"2005","unstructured":"Kirazli T, Bilgen C, Midilli R, Og\u00fct F (2005) Hearing results after primary cartilage tympanoplasty with Island technique. Otolaryngol Head Neck Surg 132(6):933\u2013937. https:\/\/doi.org\/10.1016\/j.otohns.2005.01.044","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"1","key":"9337_CR17","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/s00405-022-07477-6","volume":"280","author":"JF Lubianca Neto","year":"2023","unstructured":"Lubianca Neto JF, Schuster AK, Fanzini TA, Lubianca JPN, Mostardeiro LR, Eavey RD (2023) Comparison between endoscopic and microscopic butterfly cartilage graft inlay tympanoplasty: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 280(1):151\u2013158. https:\/\/doi.org\/10.1007\/s00405-022-07477-6","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"4","key":"9337_CR18","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1007\/s00405-014-2889-6","volume":"272","author":"M Haksever","year":"2015","unstructured":"Haksever M, Akduman D, Solmaz F, G\u00fcndo\u011fdu E (2015) Inlay butterfly cartilage tympanoplasty in the treatment of dry central perforated chronic otitis media as an effective and time-saving procedure. Eur Arch Otorhinolaryngol 272(4):867\u2013872. https:\/\/doi.org\/10.1007\/s00405-014-2889-6","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"6","key":"9337_CR19","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1111\/coa.13801","volume":"46","author":"F Simon","year":"2021","unstructured":"Simon F, Thierry B, Rabeony T, Verrier F, Elie C, Loundon N, Leboulanger N, Couloigner V, Garabedian EN, Denoyelle F (2021) Long-term outcomes of cartilage tympanoplasty in 139 ears in children. Clin Otolaryngol 46(6):1395\u20131399. https:\/\/doi.org\/10.1111\/coa.13801","journal-title":"Clin Otolaryngol"},{"issue":"2","key":"9337_CR20","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1097\/00129492-200503000-00020","volume":"26","author":"V Couloigner","year":"2005","unstructured":"Couloigner V, Baculard F, El Bakkouri W, Viala P, Fran\u00e7ois M, Narcy P, Van Den Abbeele T (2005) Inlay butterfly cartilage tympanoplasty in children. Otol Neurotol 26(2):247\u2013251. https:\/\/doi.org\/10.1097\/00129492-200503000-00020","journal-title":"Otol Neurotol"},{"issue":"1","key":"9337_CR21","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.amjoto.2012.08.004","volume":"34","author":"R Hod","year":"2013","unstructured":"Hod R, Buda I, Hazan A, Nageris BI (2013) Inlay butterfly cartilage tympanoplasty. Am J Otolaryngol 34(1):41\u201343. https:\/\/doi.org\/10.1016\/j.amjoto.2012.08.004","journal-title":"Am J Otolaryngol"},{"issue":"3","key":"9337_CR22","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1002\/ohn.597","volume":"170","author":"TC Wang","year":"2024","unstructured":"Wang TC, Shih TC, Chen CK, Hsieh VC, Lin DJ, Tien HC, Chen KC, Tsai MH, Lin CD, Tsai CH (2024) Endoscopic versus microscopic type I tympanoplasty: an updated systematic review and Meta-analysis. Otolaryngol Head Neck Surg 170(3):675\u2013693. https:\/\/doi.org\/10.1002\/ohn.597","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"9337_CR23","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1017\/S0022215123000968","volume":"138","author":"J Sun","year":"2024","unstructured":"Sun J (2024) Comparison of perichondrium-cartilage button technique and traditional over-underlay technique for repairing large perforations. J Laryngol Otol 138(2):148\u2013152. https:\/\/doi.org\/10.1017\/S0022215123000968","journal-title":"J Laryngol Otol"},{"issue":"4","key":"9337_CR24","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1007\/s00405-023-08295-0","volume":"281","author":"Z Lou","year":"2024","unstructured":"Lou Z, Lou Z, Yu D, Wang J, Lv T, Chen Z (2024) Comparison of two endoscopic perichondrium-cartilage graft underlay Myringoplasty for large perforations: a randomized controlled trial. Eur Arch Otorhinolaryngol 281(4):1773\u20131780. https:\/\/doi.org\/10.1007\/s00405-023-08295-0","journal-title":"Eur Arch Otorhinolaryngol"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09337-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-025-09337-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09337-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T19:52:05Z","timestamp":1756669925000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-025-09337-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["9337"],"URL":"https:\/\/doi.org\/10.1007\/s00405-025-09337-5","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"type":"print","value":"0937-4477"},{"type":"electronic","value":"1434-4726"}],"subject":[],"published":{"date-parts":[[2025,3,28]]},"assertion":[{"value":"6 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The report was approved by the Local Ethics Committee (Date: 23.03.2021 approval no: 269) and complied with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that they have no confict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}