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Int J Pediatr Otorhinolaryngol. 2017 May;96:127-130. doi: 10.1016/j.ijporl.2017.03.017. Epub 2017 Mar 16.

Double-handed endoscopic myringoplasty with a holding system in children: Preliminary observations.

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Department of Pediatric Otorhinolaryngology, University of Bescia, Brescia, Italy.
Department of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy.
Department of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy. Electronic address:



Endoscopic transcanal myringoplasty is a newly-introduced technique for reconstruction of tympanic membrane perforation that offers the advantage to obviate postauricular incision. The objective of this study was to evaluate the feasibility of a double-handed endoscope holder transcanal myringoplasty in children. This technique permits bimanual execution of the procedure and allows the surgeon to overcome the two significant issues of single-handed endoscope surgery, i.e. easy domination of a bloody field and smooth introduction of the graft.


A prospective non-randomized study of 10 consecutive primary endoscope holder-aided myringoplasties was performed; 3 mm or 4 mm 0° rigid endoscopes were used. A xenograft, biologic soft tissue, was applied in all cases.


All procedures were performed successfully. Duration of surgery was faster than with a single-handed procedure and varied between 20 and 60 min. The tympanic membrane healed successfully in all patients.


In this preliminary experience in children, a bimanual endoscopic holder-aided myringoplasty technique offers the possibility to overcome the obstacles encountered in a single-handed technique, since it can replicate the same concept of a bimanual microscopic approach and allow for easy management of a bloody field and introduction of the graft in the middle ear.


Hearing; Holder; Myringoplasty; Pediatric otology; Surgical otology

[Indexed for MEDLINE]

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