الفهرس 
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Abstract
The surgical technique that used to restore the integrity of tympanic membrane
is myringoplasty. This has many benefits to patients with tympanic membrane
perforation that include protection against long-term middle ear damage and
migration of squamous epithelium around the margins of perforation with possible
consequent cholesteatoma formation.
Our 100 patients selected from out-patient’s clinic of ENT department at El-
Menoufia University Hospital and presented with dry central tympanic membrane
perforation that had microscopic myringoplasty but only 50 patients had
otoendoscopic evaluation to middle ear apparatus and the tympanic opening of the
ET. The middle ear was examined with an operating microscope in different
positions. The visible anatomical areas were evaluated and recorded by performing
gentle maneuvers on the patient`s head. The middle ear was evaluated using a zero
and 30-degree rigid otoendoscope. After sterilization of the ear, trimming of the
perforation edges was done. The margins of perforations were refreshened.
Temporalis fascia graft was taken which was placed in an underlay manner medial to
handle of malleus via post-aural approach after tympano-meatal flap elevation.
Gelfoam soaked in ear drops containing antibiotics was used to stabilize the graft.
The mean age of patients was 30.2 years, 42% of patients were male and 58 %
of patients were female. In our study, otoendoscopic examination of eustachian tube
opening and middle ear status showed non-significant differences compared with
microscopic findings in group A. Our study showed a highly significant decrease in
postoperative air-bone gap. The success rate in our study was 94% in group A which
isn’t statistically significant with 84% success rate in group B.
Otoendoscopy is an important tool for assessment of middle ear status and
eustachian tube functions during myringoplasty proposing an increase in the success
rate. The endoscopic-assisted microscopic myringoplasty had a 94% rate of surgical
success for the closure of tympanic membrane defects. The result of this study
supports the use of otoendoscopy in traditional microscopic myringoplasty.