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Review of Transcanal Endoscopic Ear Surgery (TEES) and Bioengineering for Pediatric Otologic Surgery

  • PEDIATRIC OTOLARYNGOLOGY: Challenges in Pediatric Otolaryngology (W-C Hsu, Section Editor)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review advances in TEES and bioengineering for pediatric otologic surgery and reconstruction.

Recent Findings

TEES has been utilized in surgeries such as cholesteatoma removal, tympanic membrane perforation repairs (i.e., myringoplasty and tympanoplasty), ossicular chain reconstruction, and stapes surgeries. TEES has been shown to be non-inferior to traditional microscopic ear surgery in terms of safety, efficacy, and surgical efficiency. Furthermore, TEES does not increase rates of complications. Although few studies specifically examine pediatric samples, the data suggest TEES also is safe and efficacious for pediatric otologic surgeries. Regarding biomaterials, patch papers remain a mainstay scaffolding material for tympanic membrane repairs, and gelatin sponges and acellular dermal allografts are strong alternatives. Current research focuses on optimizing combinations of scaffolding materials and bioactive substances. For ossicular chain reconstruction, Plastipore®, hydroxyapatite, and titanium prosthetics are efficacious and commonly used.

Summary

Transcanal endoscopic ear surgery (TEES) has become widely used for evaluating and treating middle ear disease. In the past decade, a significant amount of research has been conducted supporting the utility and safety profiles of TEES for otologic surgeries. Biomaterials research has also significantly improved, but more research comparing biomaterial options is needed. Furthermore, additional investigation into the pediatric-specific population is needed.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Thomassin JM, Korchia D, Doris JMD. Endoscopic-guided otosurgery in the prevention of residual cholesteatomas. Otol Neurotol. 1993;103(8):939–43.

    CAS  Google Scholar 

  2. Ito T, Kubota T, Watanabe T, Futai K, Furukawa T, Kakehata S. Transcanal endoscopic ear surgery for pediatric population with a narrow external auditory canal. Int J Pediatr Otorhinolaryngol. 2015;79(12):2265–9.

    Article  PubMed  Google Scholar 

  3. Kozin ED, Gulati S, Kaplan AB, et al. Systematic review of outcomes following observational and operative endoscopic middle ear surgery. Laryngoscope. 2015;125(5):1205–14.

    Article  PubMed  Google Scholar 

  4. Migirov L, Shapira Y, Horowitz Z, Wolf M. Exclusive endoscopic ear surgery for acquired cholesteatoma preliminary results. Otol Neurotol. 2011;32(3):433–6.

    Article  PubMed  Google Scholar 

  5. Sun WH, Kuo CL, Huang TC. The anatomic applicability of transcanal endoscopic ear surgery in children. Int J Pediatr Otorhinolaryngol. 2018;105:118–22.

    Article  PubMed  Google Scholar 

  6. Huang TY, Ho KY, Wang LF, Chien CY, Wang HM. A comparative study of endoscopic and microscopic approach Type 1 tympanoplasty for simple chronic otitis media. J Int Adv Otol. 2016;12(1):28–31.

    Article  PubMed  Google Scholar 

  7. Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: a systematic review and meta-analysis. Laryngoscope. 2017;127(8):1890–6.

    Article  PubMed  Google Scholar 

  8. Manna S, Kaul VF, Gray ML, Wanna GB. Endoscopic versus microscopic middle ear surgery: a meta-analysis of outcomes following tympanoplasty and stapes surgery. Otol Neurotol. 2019;40(8):983–93.

    Article  PubMed  Google Scholar 

  9. Lakpathi G, Sudarshan Reddy L. Comparative study of endoscope assisted myringoplasty and microscopic myringoplasty. Indian J Otolaryngol Head Neck Surg. 2016;68(2):185–190.

  10. Tarabichi M. Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg. 2010;62(1):6–24.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kozin ED, Lee DJ. Basic principles of endoscopic ear surgery. Oper Tech Otolaryngol Head Neck Surg. 2017;28(1):P2-10.

    Article  Google Scholar 

  12. • Han SY, Lee DY, Chung J, Kim YH. Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta-analysis. Laryngoscope. 2019;129(6):1444–52. This meta-analysis found that using TEES over MES reduced the likelihood of residual/ recurrent cholesteatomas for pediatric patients (odds ratio: 0.56, 95% CI: 0.38-0.84). Furthermore, tympanoplasty graft success rates for pediatric patients was similar between TEES and MES (OR: 0.72, 95% CI 0.41 – 1.26).

  13. De Zinis LO, Berlucchi M, Nassif N. Double-handed endoscopic myringoplasty with a holding system in children: Preliminary observations. Int J Pediatr Otorhinolaryngol. 2017;96:127–30.

    Article  PubMed  Google Scholar 

  14. Tsetsos N, Vlachtsis K, Stavrakas M, Fyrmpas G. Endoscopic versus microscopic ossiculoplasty in chronic otitis media: a systematic review of the literature. Eur Arch Otorhinolaryngol. 2021;278(4):917–23.

    Article  PubMed  Google Scholar 

  15. Olszewska E, Wagner M, Bernal-Sprekelsen M, et al. Etiopathogenesis of cholesteatoma. Eur Arch Otorhinolaryngol. 2004;261(1):6–24.

    Article  PubMed  Google Scholar 

  16. Nevoux J, Lenoir M, Roger G, Denoyelle F, Ducou Le Pointe H, Garabedian EN. Childhood cholesteatoma. Eur Ann Otorhinolaryngol Head Neck Dis. 2010;127(4):143–150.

  17. Lynrah ZA, Bakshi J, Panda NK, Khandelwal NK. Aggressiveness of pediatric cholesteatoma. Do we have an evidence? Indian J Otolaryngol Head Neck Surg. 2013;65(3):264–268.

  18. Semaan MT, Megerian CA. The pathophysiology of cholesteatoma. Otolaryngol Clin North Am. 2006;39(6):1143–59.

    Article  PubMed  Google Scholar 

  19. Basonbul RA, Ronner EA, Kozin ED, Lee DJ, Cohen MS. systematic review of endoscopic ear surgery outcomes for pediatric cholesteatoma. Otol Neurotol. 2021;42(1):108–15.

    Article  PubMed  Google Scholar 

  20. Marchioni D, Soloperto D, Rubini A, et al. Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience. Int J Pediatr Otorhinolaryngol. 2015;79(3):316–22.

    Article  PubMed  Google Scholar 

  21. Kobayashi T, Gyo K, Komori M, Hyodo M. Efficacy and safety of transcanal endoscopic ear surgery for congenital cholesteatomas: a preliminary report. Otol Neurotol. 2015;36(10):1644–50.

    Article  PubMed  Google Scholar 

  22. Hunter JB, Zuniga MG, Sweeney AD, et al. Pediatric endoscopic cholesteatoma surgery. Otolaryngol Head Neck Surg. 2016;154(6):1121–7.

    Article  PubMed  Google Scholar 

  23. Ghadersohi S, Carter JM, Hoff SR. Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma. Laryngoscope. 2017;127(11):2653–8.

    Article  PubMed  Google Scholar 

  24. Marchioni D, Rubini A, Gonzalez-Navarro M, Alicandri-Ciufelli M, James A, Presutti L. Bilateral congenital cholesteatoma: surgical treatment and considerations. Int J Pediatr Otorhinolaryngol. 2017;99:146–51.

    Article  PubMed  Google Scholar 

  25. Glikson E, Feinmesser G, Sagiv D, Wolf M, Migirov L, Shapira Y. Trans-canal endoscopic ear surgery and canal wall-up tympano-mastoidectomy for pediatric middle ear cholesteatoma. Eur Arch Otorhinolaryngol. 2019;276(11):3021–6.

    Article  PubMed  Google Scholar 

  26. Kountakis SE. Encyclopedia of Otolaryngology, Head and Neck Surgery. 2013.

  27. Glasscock ME, Jackson CG, Nissen AJ, Schwaber MK. Postauricular undersurface tympanic membrane grafting: a follow-up report. Laryngoscope. 1982;92(7):718–27.

    Article  PubMed  Google Scholar 

  28. Sheehy JL, Anderson RG. Myringoplasty. A review of 472 cases. Ann Otol Rhinol Laryngol. 1980;89(4):331–334.

  29. Rizer FM. Overlay versus underlay tympanoplasty. Part II: the study Laryngoscope. 1997;107(12):26–36.

    CAS  Google Scholar 

  30. Hardman J, Muzaffar J, Nankivell P, Coulson C. Tympanoplasty for chronic tympanic membrane perforation in children: systematic review and meta-analysis. Otol Neurotol. 2015;36(5):796–804.

    Article  PubMed  Google Scholar 

  31. El-Guindy A. Endoscopic transcanal myringoplasty. J Laryngol Otol. 1992;106(6):493–5.

    Article  CAS  PubMed  Google Scholar 

  32. Tarabichi M. Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol. 1999;108(1):39–46.

    Article  CAS  PubMed  Google Scholar 

  33. Raj A, Meher R. Endoscopic transcanal myringoplasty - a study. Indian J Otolaryngol Head Neck Surg. 2001;53(1):47–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Usami S, Iijima N, Fujita S, Takumi Y. Endoscopic-assisted myringoplasty. ORL J Otorhinolaryngol Relat Spec. 2001;63(5):287–90.

    Article  CAS  PubMed  Google Scholar 

  35. Karhuketo TS, Ilomaki JH, Puhakka HJ. Tympanoscope-assisted myringoplasty. ORL J Otorhinolaryngol Relat Spec. 2001;63(6):353–7.

    Article  CAS  PubMed  Google Scholar 

  36. Yadav SP, Aggarwal N, Julaha M, Goel A. Endoscope-assisted myringoplasty. Singapore Med J. 2009;50(5):510–2.

    CAS  PubMed  Google Scholar 

  37. Mohindra S, Panda NK. Ear surgery without microscope; is it possible. Indian J Otolaryngol Head Neck Surg. 2010;62(2):138–41.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Tarabichi M, Ayache S, Nogueira JF, Qahtani MA, Pothier DD. Endoscopic management of chronic otitis media and tympanoplasty. Otolaryngol Clin North Am. 2013;46(2):155–63.

    Article  PubMed  Google Scholar 

  39. Ayache S. Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol. 2013;270(3):853–60.

    Article  PubMed  Google Scholar 

  40. Furukawa T, Watanabe T, Ito T, Kubota T, Kakehata S. Feasibility and advantages of transcanal endoscope myringoplasty. Otol Neurotol. 2014;35(4):e140-145.

    Article  PubMed  Google Scholar 

  41. Eren SB, Tugrul S, Ozucer B, Veyseller B, Aksoy F, Ozturan O. Endoscopic transcanal inlay myringoplasty: alternative approach for anterior perforations. Otolaryngol Head Neck Surg. 2015;153(5):891–3.

    Article  PubMed  Google Scholar 

  42. Celik H, Samim E, Oztuna D. Endoscopic, “push-trough” technique cartilage myringoplasty in anterior tympanic membrane perforations. Clin Exp Otorhinolaryngol. 2015;8(3):224–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Migirov L, Wolf M. Transcanal microscope-assisted endoscopic myringoplasty in children. BMC Pediatr. 2015;15:32.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Awad OG, Hamid KA. Endoscopic type 1 tympanoplasty in pediatric patients using tragal cartilage. JAMA Otolaryngol Head Neck Surg. 2015;141(6):532–8.

    Article  PubMed  Google Scholar 

  45. Kuo CH, Wu HM. Comparison of endoscopic and microscopic tympanoplasty. Eur Arch Otorhinolaryngol. 2017;274(7):2727–32.

    Article  PubMed  Google Scholar 

  46. Tan HE, Santa Maria PL, Eikelboom RH, Anandacoomaraswamy KS, Atlas MD. Type I Tympanoplasty meta-analysis: a single variable analysis. Otol Neurotol. 2016;37(7):838–46.

    Article  PubMed  Google Scholar 

  47. Mudhol RS, Naragund AI, Shruthi VS. Ossiculoplasty: revisited. Indian J Otolaryngol Head Neck Surg. 2013;65(Suppl 3):451–4.

    Article  CAS  PubMed  Google Scholar 

  48. Das A, Mitra S, Ghosh D, Sengupta A. Endoscopic ossiculoplasty: is there any edge over the microscopic technique? Laryngoscope. 2020;130(3):797–802.

    Article  PubMed  Google Scholar 

  49. Guneri EA, Cakir CA. Ossicular chain reconstruction: endoscopic or microscopic? J Laryngol Otol. 2020;134(12):1108–14.

    Article  CAS  PubMed  Google Scholar 

  50. Yawn RJ, Hunter JB, O’Connell BP, et al. Audiometric outcomes following endoscopic ossicular chain reconstruction. Otol Neurotol. 2017;38(9):1296–300.

    Article  PubMed  Google Scholar 

  51. Caloway CL, Basonbul RA, Ronner EA, et al. Pediatric endoscopic ossiculoplasty following surgery for chronic ear disease. Laryngoscope. 2020;130(12):2896–9.

    Article  PubMed  Google Scholar 

  52. Chung J, Kang JY, Kim MS, Kim B, Choi JW. Microscopic vs endoscopic ear surgery for congenital ossicular anomaly. Otolaryngol Head Neck Surg. 2020;162(4):548–53.

    Article  PubMed  Google Scholar 

  53. Ito T, Kubota T, Furukawa T, Matsui H, Futai K, Kakehata S. Transcanal endoscopic ear surgery for congenital middle ear anomalies. Otol Neurotol. 2019;40(10):1299–305.

    Article  PubMed  Google Scholar 

  54. Kim MS, Chung J, Kang JY, Choi JW. Transcanal endoscopic ear surgery for traumatic ossicular injury. Acta Otolaryngol. 2020;140(1):22–6.

    Article  PubMed  Google Scholar 

  55. Potsangbam DS, Akoijam BA. Endoscopic transcanal autologous cartilage ossiculoplasty. Indian J Otolaryngol Head Neck Surg. 2019;71(1):54–9.

    Article  PubMed  Google Scholar 

  56. Zhang C, Mi J, Long D, Deng Y, Sun Q, Liu Z. Endoscopic ossiculoplasty for the management of isolated congenital ossicular chain malformation: surgical results in 16 ears. Ear Nose Throat J. 2021;100(8):585–92.

    Article  PubMed  Google Scholar 

  57. Iannella G, De Vincentiis M, Greco A, et al. Endoscopic approach in second stage ossicular chain reconstruction. Am J Otolaryngol. 2019;40(5):735–42.

    Article  PubMed  Google Scholar 

  58. Yoshida A, Hosoya M, Kanzaki S, Fujioka M, Ozawa H. Transcanal endoscopic ear surgery for management of ossicular malformation: clinical outcomes of 17 cases. Acta Otolaryngol. 2022;142(2):154–60.

    Article  PubMed  Google Scholar 

  59. Zhu VF, Kou YF, Lee KH, Kutz JW Jr, Isaacson B. Transcanal endoscopic ear surgery for the management of congenital ossicular fixation. Otol Neurotol. 2016;37(8):1071–6.

    Article  PubMed  Google Scholar 

  60. Wu CC, Chen YH, Yang TH, et al. Endoscopic versus microscopic management of congenital ossicular chain anomalies: our experiences with 29 patients. Clin Otolaryngol. 2017;42(4):944–50.

    Article  CAS  PubMed  Google Scholar 

  61. Kwinter A, Purcell PL, Leonard CG, James AL. Comparing transcanal endoscopic ear surgery to post-auricular microscope-guided surgery in pediatric ossiculoplasty: hearing outcomes and post-operative pain. Otol Neurotol. 2021;42(10):e1648–51.

    Article  PubMed  Google Scholar 

  62. Bartel R, Sanz JJ, Clemente I, et al. Endoscopic stapes surgery outcomes and complication rates: a systematic review. Eur Arch Otorhinolaryngol. 2021;278(8):2673–9.

    Article  PubMed  Google Scholar 

  63. Ho S, Patel P, Ballard D, Rosenfeld R, Chandrasekhar S. Systematic review and meta-analysis of endoscopic vs microscopic stapes surgery for stapes fixation. Otolaryngol Head Neck Surg. 2021;165(5):626–35.

    Article  PubMed  Google Scholar 

  64. Koukkoullis A, Toth I, Gede N, et al. Endoscopic versus microscopic stapes surgery outcomes: a meta-analysis and systematic review. Laryngoscope. 2020;130(8):2019–27.

    Article  PubMed  Google Scholar 

  65. Fang L, Xu J, Wang W, Huang Y. Would endoscopic surgery be the gold standard for stapes surgery in the future? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2021;278(4):925–32.

    Article  PubMed  Google Scholar 

  66. Nikolaos T, Aikaterini T, Dimitrios D, et al. Does endoscopic stapedotomy increase hearing restoration rates comparing to microscopic? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2018;275(12):2905–13.

    Article  PubMed  Google Scholar 

  67. Pauna HF, Pereira RC, Monsanto RC, Amaral MSA, Hyppolito MA. A comparison between endoscopic and microscopic approaches for stapes surgery: a systematic review. J Laryngol Otol. 2020;134(5):398–403.

    Article  CAS  PubMed  Google Scholar 

  68. Hoskison EE, Harrop E, Jufas N, Kong JHK, Patel NP, Saxby AJ. Endoscopic Stapedotomy: A Systematic Review. Otol Neurotol. 2021;42(10):e1638–43.

    Article  PubMed  Google Scholar 

  69. Hall AC, Mandavia R, Selvadurai D. Total endoscopic stapes surgery: systematic review and pooled analysis of audiological outcomes. Laryngoscope. 2020;130(5):1282–6.

    Article  PubMed  Google Scholar 

  70. Hajiioannou J, Gkrinia E, Tzimkas-Dakis K, et al. Microscopic versus endoscopic stapes surgery: a systematic review and metanalysis. J Laryngol Otol. 2022:1–25.

  71. Tolisano AM, Fontenot MR, Nassiri AM, et al. Pediatric stapes surgery: hearing and surgical outcomes in endoscopic vs microscopic approaches. Otolaryngol Head Neck Surg. 2019;161(1):150–6.

    Article  PubMed  Google Scholar 

  72. Sakagami M, Yuasa R, Yuasa Y. Simple underlay myringoplasty. J Laryngol Otol. 2007;121(9):840–4.

    Article  CAS  PubMed  Google Scholar 

  73. Koc S, Akyuz S, Gurbuzler L, Aksakal C. Fat graft myringoplasty with the newly developed surgical technique for chronic tympanic membrane perforation. Eur Arch Otorhinolaryngol. 2013;270(5):1629–33.

    Article  PubMed  Google Scholar 

  74. Lee DY, Kim YH. Can Fat-plug myringoplasty be a good alternative to formal myringoplasty? A systematic review and meta-analysis. Otol Neurotol. 2018;39(4):403–9.

    Article  PubMed  Google Scholar 

  75. Shiomi Y, Shiomi Y. Surgical outcomes of myringoplasty using platelet-rich plasma and evaluation of the outcome-associated factors. Auris Nasus Larynx. 2020;47(2):191–7.

    Article  PubMed  Google Scholar 

  76. Hong P, Bance M, Gratzer PF. Repair of tympanic membrane perforation using novel adjuvant therapies: a contemporary review of experimental and tissue engineering studies. Int J Pediatr Otorhinolaryngol. 2013;77(1):3–12.

    Article  PubMed  Google Scholar 

  77. Johnson AP, Smallman LA, Kent SE. The mechanism of healing of tympanic membrane perforations. A two-dimensional histological study in guinea pigs. Acta Otolaryngol. 1990;109(5–6):406–415.

  78. Chung C, Burdick JA. Engineering cartilage tissue. Adv drug deliv rev. 2008;60(2):243–62.

    Article  CAS  PubMed  Google Scholar 

  79. Pribitkin EA, Handler SD, Tom LW, Potsic WP, Wetmore RF. Ventilation tube removal. Indications for paper patch myringoplasty. Arch Otolaryngol Head Neck Surg. 1992;118(5):495–497.

  80. Kartush JM. Tympanic membrane patcher: a new device to close tympanic membrane perforations in an office setting. Am J Otol. 2000;21(5):615–20.

    CAS  PubMed  Google Scholar 

  81. • Simani L, Oron Y, Handzel O, et al. Paper patching versus watchful waiting of traumatic tympanic membrane perforations: a meta-analysis. Laryngoscope. 2021;131(9):2091–7. This meta-analysis shows the benefits of patch papers (a common standard of tympanic membrane perforations) over watchful waiting in terms of increased healing rates RR 1.12, 95% CI 1.04-1.21.

  82. Niklasson A, Tano K. The Gelfoam(R) plug: an alternative treatment for small eardrum perforations. Laryngoscope. 2011;121(4):782–4.

    Article  PubMed  Google Scholar 

  83. Lou Z-C, He J-G. A randomised controlled trial comparing spontaneous healing, gelfoam patching and edge-approximation plus gelfoam patching in traumatic tympanic membrane perforation with inverted or everted edges. Clin Otolaryngol. 2011;36(6):221–6.

    Article  PubMed  Google Scholar 

  84. Lou ZC, Lou Z. Efficacy of EGF and gelatin sponge for traumatic tympanic membrane perforations: a randomized controlled study. Otolaryngol Head Neck Surg. 2018;159(6):1028–36.

    Article  PubMed  Google Scholar 

  85. Jin ZH, Dong YH, Lou ZH. The effects of fibroblast growth factor-2 delivered via a Gelfoam patch on the regeneration of myringosclerotic traumatic eardrum perforations lying close to the malleus. Am J Otolaryngol. 2017;38(5):582–7.

    Article  PubMed  Google Scholar 

  86. Saeedi M, Ajalloueian M, Zare E, et al. The effect of PRP-enriched Gelfoam on chronic tympanic membrane perforation: a double-blind randomized clinical trial. Int Tinnitus J. 2017;21(2):108–11.

    Article  PubMed  Google Scholar 

  87. Saadat D, Ng M, Vadapalli S, Sinha UK. Office myringoplasty with alloderm. Laryngoscope. 2001;111(1):181–4.

    Article  CAS  PubMed  Google Scholar 

  88. Fayad JN, Baino T, Parisier SC. Preliminary results with the use of AlloDerm in chronic otitis media. Laryngoscope. 2003;113(7):1228–30.

    Article  PubMed  Google Scholar 

  89. Fishman AJ, Marrinan MS, Huang TC, Kanowitz SJ. Total tympanic membrane reconstruction: AlloDerm versus temporalis fascia. Otolaryngol Head Neck Surg. 2005;132(6):906–15.

    Article  PubMed  Google Scholar 

  90. Yang Z, Wu X, Chen X, et al. Comparison of type I tympanoplasty with acellular dermal allograft and cartilage perichondrium. Acta Otolaryngol. 2019;139(10):833–6.

    Article  PubMed  Google Scholar 

  91. Vos JD, Latev MD, Labadie RF, Cohen SM, Werkhaven JA, Haynes DS. Use of AlloDerm in type I tympanoplasty: a comparison with native tissue grafts. Laryngoscope. 2005;115(9):1599–602.

    Article  PubMed  Google Scholar 

  92. Benecke JE Jr. Tympanic membrane grafting with alloderm. Laryngoscope. 2001;111(9):1525–7.

    Article  PubMed  Google Scholar 

  93. Lee JM, Seo YJ, Shim DB, Lee HJ, Kim SH. Surgical outcomes of tympanoplasty using a sterile acellular dermal allograft: a prospective randomised controlled study. Acta Otorhinolaryngol Ital. 2018;38(6):554–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Raj A, Sayal A, Meher R. Sutureless tympanoplasty using acellular dermis. Am J Otolaryngol. 2011;32(2):96–9.

    Article  PubMed  Google Scholar 

  95. Min J, Kim SH. Comparison of transcanal endoscopic tympanoplasty with sterile acellular dermal allograft to conventional endaural microscopic tympanoplasty with tragal perichondrium. Am J Otolaryngol. 2018;39(2):167–70.

    Article  PubMed  Google Scholar 

  96. Lai P, Propst EJ, Papsin BC. Lateral graft type 1 tympanoplasty using AlloDerm for tympanic membrane reconstruction in children. Int J Pediatr Otorhinolaryngol. 2006;70(8):1423–9.

    Article  PubMed  Google Scholar 

  97. Prior M, Gibbins N, John G, Rhys-Williams S, Scott P. Hyaluronic acid ester in myringoplasty. J Laryngol Otol. 2008;122(2): e3.

    Article  CAS  PubMed  Google Scholar 

  98. Lee JH, Lee JS, Kim DK, Park CH, Lee HR. Clinical outcomes of silk patch in acute tympanic membrane perforation. Clin Exp Otorhinolaryngol. 2015;8(2):117–22.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Lee JH, Kim DK, Park HS, et al. A prospective cohort study of the silk fibroin patch in chronic tympanic membrane perforation. Laryngoscope. 2016;126(12):2798–803.

    Article  CAS  PubMed  Google Scholar 

  100. Jun HJ, Oh K-H, Yoo J, et al. A new patch material for tympanic membrane perforation by trauma: the membrane of a hen egg shell. Acta Otolaryngol. 2014;134(3):250–4.

    Article  PubMed  Google Scholar 

  101. Jung JY, Yun HC, Kim TM, et al. Analysis of effect of eggshell membrane patching for moderate-to-large traumatic tympanic membrane perforation. J Audiol Otol. 2017;21(1):39–43.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Farhadi M, Mirzadeh H, Solouk A, et al. Collagen-immobilized patch for repairing small tympanic membrane perforations: in vitro and in vivo assays. J Biomed Mater Res A. 2012;100(3):549–53.

    Article  PubMed  CAS  Google Scholar 

  103. Weber DE, Semaan MT, Wasman JK, Beane R, Bonassar LJ, Megerian CA. Tissue-engineered calcium alginate patches in the repair of chronic chinchilla tympanic membrane perforations. Laryngoscope. 2006;116(5):700–4.

    Article  CAS  PubMed  Google Scholar 

  104. Rubinstein BJ, Ranney JD, Khoshakhlagh P, Strasnick B, Horn-Ranney EL. A novel gel patch for minimally invasive repair of tympanic membrane perforations. Int J Pediatr Otorhinolaryngol. 2018;115:27–32.

    Article  PubMed  Google Scholar 

  105. Hakuba N, Tabata Y, Hato N, Fujiwara T, Gyo K. Gelatin hydrogel with basic fibroblast growth factor for tympanic membrane regeneration. Otol Neurotol. 2014;35(3):540–4.

    Article  PubMed  Google Scholar 

  106. Wieland AM, Sundback CA, Hart A, Kulig K, Masiakos PT, Hartnick CJ. Poly(glycerol sebacate)-engineered plugs to repair chronic tympanic membrane perforations in a chinchilla model. Otolaryngol Head Neck Surg. 2010;143(1):127–33.

    Article  PubMed  Google Scholar 

  107. Lou ZC, Lou ZH, Xiao J. Regeneration of the tympanic membrane using fibroblast growth factor-2. J Laryngol Otol. 2018;132(6):470–8.

    Article  PubMed  Google Scholar 

  108. Roosli C, von Buren T, Gassmann NB, Huber AM. The impact of platelet-derived growth factor on closure of chronic tympanic membrane perforations: a randomized, double-blind, placebo-controlled study. Otol Neurotol. 2011;32(8):1224–9.

    Article  PubMed  Google Scholar 

  109. Yung MW. Literature review of alloplastic materials in ossiculoplasty. J Laryngol Otol. 2003;117(6):431–6.

    Article  CAS  PubMed  Google Scholar 

  110. Hall A, Rytzner C. Stapedectomy and autotransplantation of ossicles. Acta Otolaryngol. 1957;47(4):318–24.

    Article  CAS  PubMed  Google Scholar 

  111. Wullstein HL. Operationen am Mittelohr mit Hilfe des freien Spaltlappen-Transplantates. Arch Otorhinolaryngol. 1952;161:422–35.

    Article  Google Scholar 

  112. Hayden GD. Results with the polyethylene T-strut in the restoration of hearing. Laryngoscope. 1961;71:504–11.

    Article  CAS  PubMed  Google Scholar 

  113. Goldman JL, Nalebuff DJ, Druss JG. Experimental observations on prosthetic materials in stapedial surgery with special reference to the use of teflon. Laryngoscope. 1962;72:169–81.

    Article  CAS  PubMed  Google Scholar 

  114. Palva T, Palva A, Karja J. Results with 2- or 3-legged wire columellization in chronic ear surgery. Ann Otol Rhinol Laryngol. 1971;80(5):760–5.

    Article  CAS  PubMed  Google Scholar 

  115. Shea J. Plastipore total ossicular replacement prosthesis. Laryngoscope. 1976;86(2):239–40.

    Article  CAS  PubMed  Google Scholar 

  116. Shea JJ, Homsy CA. The use of Proplast TM in otologic surgery. Laryngoscope. 1974;84(10):1835–45.

    Article  CAS  PubMed  Google Scholar 

  117. Jahnke K, Plester D, Heimke G. Aluminiumoxide-keramik, ein bioinertes material fur die mittellohrchirugie. Arch Otorhinolaryngol. 1979;223:373–6.

    Article  Google Scholar 

  118. Merwin GE. Bioglass middle ear prosthesis: preliminary report. Ann Otol Rhinol Laryngol. 1986;95(1):78–82.

    Article  CAS  PubMed  Google Scholar 

  119. Podoshin L, Fradis M, Gertner R. Carbon-carbon middle ear prosthesis: a preliminary clinical human trial report. Otolaryngol Head Neck Surg. 1988;99(3):278–81.

    Article  CAS  PubMed  Google Scholar 

  120. Dalchow CV, Grün D, Stupp HF. Reconstruction of the ossicular chain with titanium implants. Otolaryngol Head Neck Surg. 2001;125(6):628–30.

    Article  CAS  PubMed  Google Scholar 

  121. Grote JJ. Tympanoplasty with calcium phosphate. Arch Otolaryngol. 1984;110(3):197–9.

    Article  CAS  PubMed  Google Scholar 

  122. Brewis C, Orrell J, Yung MW. Ceravital revisited: lessons to be learned. Otol Neurotol. 2003;24(1):20–3.

    Article  CAS  PubMed  Google Scholar 

  123. Yamamoto E. Long-term observations on ceramic ossicular replacement prosthesis (CORP). Laryngoscope. 1988;98(4):402–4.

    Article  CAS  PubMed  Google Scholar 

  124. Plester D, Jahnke K. Ceramic implants in otologic surgery. Am J Otol. 1981;3(2):104–8.

    CAS  PubMed  Google Scholar 

  125. Reineke U, Ebmeyer J, Plett D, Winkler H, Sudhoff H. Superelastic nitinol stapes prostheses. Laryngorhinootologie. 2010;89(5):271–5.

    Article  CAS  PubMed  Google Scholar 

  126. Teschner M, Lilli G, Lenarz T. Comparison of superelastic nitinol stapes prostheses and platin teflon stapes prostheses. Eur Arch Otorhinolaryngol. 2019;276(9):2405–9.

    Article  PubMed  Google Scholar 

  127. Fong JC, Michael P, Raut V. Titanium versus autograft ossiculoplasty. Acta Otolaryngol. 2010;130(5):554–8.

    Article  PubMed  Google Scholar 

  128. Zakzouk A, Bonmardion N, Bouchetemble P, Lerosey Y, Marie JP. Titanium prosthesis or autologous incus for total ossicular reconstruction in the absence of the stapes suprastructure and presence of mobile footplate. Eur Arch Otorhinolaryngol. 2015;272(10):2653–7.

    Article  PubMed  Google Scholar 

  129. Amith N, Rs M. Autologous incus versus titanium partial ossicular replacement prosthesis in reconstruction of Austin type A ossicular defects: a prospective randomised clinical trial. J Laryngol Otol. 2017;131(5):391–8.

    Article  PubMed  Google Scholar 

  130. Orfao T, Julio S, Ramos JF, Dias CC, Silveira H, Santos M. Audiometric outcome comparison between titanium prosthesis and molded autologous material. Otolaryngol Head Neck Surg. 2014;151(2):315–20.

    Article  PubMed  Google Scholar 

  131. Sevik Elicora S, Erdem D, Dinc AE, Damar M, Biskin S. The effects of surgery type and different ossiculoplasty materials on the hearing results in cholesteatoma surgery. Eur Arch Otorhinolaryngol. 2017;274(2):773–80.

    Article  PubMed  Google Scholar 

  132. Nikolaou A, Bourikas Z, Maltas V, Aidonis A. Ossiculoplasty with the use of autografts and synthetic prosthetic materials: a comparison of results in 165 cases. J Laryngol Otol. 1992;106(8):692–4.

    Article  CAS  PubMed  Google Scholar 

  133. Zhao L, Li J, Gong S. Comparison of the application of artificial ossicles and autologous ossicles in the reconstruction of a damaged ossicular chain. J Laryngol Otol. 2018;132(10):885–90.

    Article  CAS  PubMed  Google Scholar 

  134. Hajela A, Kumar S, Singh HP, Verma V. Comparison of ossiculoplasty using autograft ossicle versus allograft (Teflon). Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 2):1309–13.

    Article  PubMed  Google Scholar 

  135. Jung DJ, Yoo MH, Lee KY. Comparison of ossiculoplasty outcomes using different materials in the treatment of chronic otitis media. Otol Neurotol. 2021;42(1):76–81.

    Article  PubMed  Google Scholar 

  136. Shea JJ, Emmett JR. Biocompatible ossicular implants. Arch Otolaryngol. 1978;104(4):191–6.

    Article  CAS  PubMed  Google Scholar 

  137. Smyth GD. TORPs–how have they fared after five years? J Laryngol Otol. 1983;97(11):991–3.

    Article  CAS  PubMed  Google Scholar 

  138. House JW, Teufert KB. Extrusion rates and hearing results in ossicular reconstruction. Otolaryngol Head Neck Surg. 2001;125(3):135–41.

    Article  CAS  PubMed  Google Scholar 

  139. Bayazit Y, Göksu N, Beder L. Function results of Plastipore prostheses for middle ear ossicular chain reconstruction. Laryngoscope. 1999;109(5):709–11.

    Article  CAS  PubMed  Google Scholar 

  140. Brackmann DE, Sheehy JL, Luxford WM. TORPs and PORPs in tympanoplasty: a review of 1042 operations. Otolaryngol Head Neck Surg. 1984;92(1):32–7.

    Article  CAS  PubMed  Google Scholar 

  141. Jackson CG, Glasscock ME 3rd, Schwaber MK, Nissen AJ, Christiansen SG, Smith PG. Ossicular chain reconstruction: the TORP and PORP in chronic ear disease. Laryngoscope. 1983;93(8):981–8.

    Article  CAS  PubMed  Google Scholar 

  142. Slater PW, Rizer FM, Schuring AG, Lippy WH. Practical use of total and partial ossicular replacement prostheses in ossiculoplasty. Laryngoscope. 1997;107(9):1193–8.

    Article  CAS  PubMed  Google Scholar 

  143. Eleftheriadou A, Chalastras T, Georgopoulos S, et al. Long-term results of plastipore prostheses in reconstruction of the middle ear ossicular chain. ORL J Otorhinolaryngol Relat Spec. 2009;71(5):284–8.

    Article  CAS  PubMed  Google Scholar 

  144. Berenholz LP, Burkey JM, Lippy WH. Short- and long-term results of ossicular reconstruction using partial and total plastipore prostheses. Otol Neurotol. 2013;34(5):884–9.

    Article  PubMed  Google Scholar 

  145. Mangham CA, Lindeman RC. Ceravital versus plastipore in tympanoplasty: A randomized prospective trial. Ann Otol Rhinol Laryngol. 1990;99(2):112–6.

    Article  CAS  PubMed  Google Scholar 

  146. Hillman TA, Shelton C. Ossicular chain reconstruction: titanium versus plastipore. Laryngoscope. 2003;113(10):1731–5.

    Article  PubMed  Google Scholar 

  147. Doi T, Hosoda Y, Kaneko T, et al. Hearing results for ossicular reconstruction using a cartilage-connecting hydroxyapatite prosthesis with a spearhead. Otol Neurotol. 2007;28(8):1041–1044.

  148. Shinohara T, Gyo K, Saiki T, Yanagihara N. Ossiculoplasty using hydroxyapatite prostheses: long-term results. Clin Otolaryngol Allied Sci. 2000;25(4):287–92.

    Article  CAS  PubMed  Google Scholar 

  149. Truy E, Naiman AN, Pavillon C, Abedipour D, Lina-Granade G, Rabilloud M. Hydroxyapatite versus titanium ossiculoplasty. Otol Neurotol. 2007;28(4):492–8.

    Article  PubMed  Google Scholar 

  150. Vrabec JT, Stierman K, Grady JJ. Hydroxyapatite prosthesis extrusion. Otol Neurotol. 2002;23(5):653–6.

    Article  PubMed  Google Scholar 

  151. Gerard JM, De Bie G, Franceschi D, Deggouj N, Gersdorff M. Ossiculoplasty with hydroxyapatite bone cement: our reconstruction philosophy. Eur Arch Otorhinolaryngol. 2015;272(7):1629–35.

    Article  PubMed  Google Scholar 

  152. Rondini-Gilli E, Grayeli AB, Crosara PFTB, et al. Ossiculoplasty with total hydroxylapatite prostheses anatomical and functional outcomes. Otol Neurotol. 2003;24(4):543–7.

    Article  PubMed  Google Scholar 

  153. Yung M, Smith P. Titanium versus nontitanium ossicular prostheses-a randomized controlled study of the medium-term outcome. Otol Neurotol. 2010;31(5):752–8.

    Article  PubMed  Google Scholar 

  154. Zhang LC, Zhang TY, Dai PD, Luo JF. Titanium versus non-titanium prostheses in ossiculoplasty: a meta-analysis. Acta Otolaryngol. 2011;131(7):708–15.

    Article  CAS  PubMed  Google Scholar 

  155. Begall K, Zimmermann H. Reconstruction of the ossicular chain with titanium implants. Results of a multicenter study Laryngorhinootologie. 2000;79(3):139–45.

    Article  CAS  PubMed  Google Scholar 

  156. Wang X, Song J, Wang H. Results of tympanoplasty with titanium prostheses. Otolaryngol Head Neck Surg. 1999;121(5):606–9.

    Article  CAS  PubMed  Google Scholar 

  157. Kahue CN, O’Connnell BP, Dedmon MM, Haynes DS, Rivas A. Short and long-term outcomes of titanium clip ossiculoplasty. Otol Neurotol. 2018;39(6):e453–60.

    Article  PubMed  Google Scholar 

  158. Lahlou G, Sonji G, De Seta D, et al. Anatomical and functional results of ossiculoplasty using titanium prosthesis. Acta Otorhinolaryngol Ital. 2018;38(4):377–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  159. Mulazimoglu S, Saxby A, Schlegel C, Linder T. Titanium incus interposition ossiculoplasty: audiological outcomes and extrusion rates. Eur Arch Otorhinolaryngol. 2017;274(9):3303–10.

    Article  PubMed  Google Scholar 

  160. de Zinis LOR. Titanium vs hydroxyapatite ossiculoplasty in canal wall down mastoidectomy. Arch Otolaryngol Head Neck Surg. 2008;134(12):1283–7.

    Article  Google Scholar 

  161. Mantsopoulos K, Thimsen V, Taha L, et al. Comparative analysis of titanium clip prostheses for partial ossiculoplasty. Am J Otolaryngol. 2021;42(5): 103062.

    Article  CAS  PubMed  Google Scholar 

  162. Fayad JN, Ursick J, Brackmann DE, Friedman RA. Total ossiculoplasty: short- and long-term results using a titanium prosthesis with footplate shoe. Otol Neurotol. 2014;35(1):108–13.

    Article  PubMed  Google Scholar 

  163. Gostian AO, Pazen D, Luers JC, Huttenbrink KB, Beutner D. Titanium ball joint total ossicular replacement prosthesis–experimental evaluation and midterm clinical results. Hear Res. 2013;301:100–4.

    Article  CAS  PubMed  Google Scholar 

  164. Haberman RS 2nd, Salapatas AM. Hearing outcomes after ossicular reconstruction with removal of the malleus. Otolaryngol Head Neck Surg. 2018;158(1):144–50.

    Article  PubMed  Google Scholar 

  165. Wood CB, Yawn R, Lowery AS, O’Connell BP, Haynes D, Wanna GB. Long-term hearing outcomes following total ossicular reconstruction with titanium prostheses. Otolaryngol Head Neck Surg. 2019;161(1):123–9.

    Article  PubMed  Google Scholar 

  166. Ocak E, Beton S, Meco C, Dursun G. Titanium versus hydroxyapatite prostheses: comparison of hearing and anatomical outcomes after ossicular chain reconstruction. Turk Arch Otorhinolaryngol. 2015;53(1):15–8.

    Article  PubMed  PubMed Central  Google Scholar 

  167. Quesnel S, Teissier N, Viala P, Couloigner V, Van Den Abbeele T. Long term results of ossiculoplasties with partial and total titanium Vario Kurz prostheses in children. Int J Pediatr Otorhinolaryngol. 2010;74(11):1226–9.

    Article  CAS  PubMed  Google Scholar 

  168. Nevoux J, Moya-Plana A, Chauvin P, Denoyelle F, Garabedian E-N. Total ossiculoplasty in children: predictive factors and long-term follow-up. Arch Otolaryngol Head Neck Surg. 2011;137(12):1240–6.

    Article  PubMed  Google Scholar 

  169. Wolter NE, Holler T, Cushing SL, et al. Pediatric ossiculoplasty with titanium total ossicular replacement prosthesis. Laryngoscope. 2015;125(3):740–5.

    Article  PubMed  Google Scholar 

  170. Govil N, Kaffenberger TM, Shaffer AD, Chi DH. Factors influencing hearing outcomes in pediatric patients undergoing ossicular chain reconstruction. Int J Pediatr Otorhinolaryngol. 2017;99:60–5.

    Article  PubMed  Google Scholar 

  171. Choi YS, Shin SO. Results of hearing outcome according to the alloplastic ossicular prosthesis materials. Indian J Otolaryngol Head Neck Surg. 2018;70(2):184–7.

    Article  PubMed  Google Scholar 

  172. Faramarzi M, Jahangiri R, Roosta S. Comparison of titanium vs. polycel total ossicular replacement prosthesis. Iran J Otorhinolaryngol. 2016;28(85):89–97.

  173. Kwok P, Fisch U, Strutz J, Jacob P. Comparative electron microscopic study of the surface structure of gold, Teflon, and titanium stapes prostheses. Otol Neurotol. 2001;22(5):608–13.

    Article  CAS  PubMed  Google Scholar 

  174. Sevy A, Arriaga M. The stapes prosthesis: past, present, and future. Otolaryngol Clin North Am. 2018;51(2):393–404.

    Article  PubMed  Google Scholar 

  175. Green JD Jr, McElveen JT Jr. Next generation shape memory prosthesis (NiTiBOND) for stapedotomy: Short-term results. Laryngoscope. 2017;127(4):915–20.

    Article  PubMed  Google Scholar 

  176. Koukkoullis A, Gerlinger I, Kovacs A, et al. Comparing intermediate-term hearing results of NiTiBOND and Nitinol prostheses in stapes surgery. J Laryngol Otol. 2021;135(9):795–8.

    Article  CAS  PubMed  Google Scholar 

  177. Revesz P, Szanyi I, Rath G, et al. Comparison of hearing results following the use of NiTiBOND versus Nitinol prostheses in stapes surgery: a retrospective controlled study reporting short-term postoperative results. Eur Arch Otorhinolaryngol. 2016;273(5):1131–6.

  178. Brar T, Passey JC, Agarwal AK. Comparison of hearing outcome using a Nitinol versus Teflon prosthesis in stapedotomy. Acta Otolaryngol. 2012;132(11).

  179. Reis LR, Donato M, Almeida G, Castelhano L, Escada P. Nitinol versus non-Nitinol prostheses in otosclerosis surgery: a meta-analysis. Acta Otorhinolaryngol Ital. 2018;38(4):279–85.

    Article  PubMed  PubMed Central  Google Scholar 

  180. Huber AM, Ma F, Felix H, LInder T. Stapes prosthesis attachment: the effect of crimping on sound transfer in otosclerosis surgery. Laryngoscope. 2003;113(5):853–858.

  181. Rajan GP, Diaz J, Blackham R, et al. Eliminating the limitations of manual crimping in stapes surgery: mid-term results of 90 patients in the Nitinol stapes piston multicenter trial. Laryngoscope. 2007;117(7):1236–9.

    Article  PubMed  Google Scholar 

  182. Fayad JN, Semaan MT, Meier JC, House JW. Hearing Results Using the SMart Piston Prosthesis. Otol Neurotol. 2009;30(8):1122–7.

    Article  PubMed  Google Scholar 

  183. Kuo C-L, Wang M-C, Shiao A-S. Superiority of nitinol piston over conventional prostheses in stapes surgery: first comparative results in the Chinese population in Taiwan. J Chin Med Assoc. 2010;73(5):241–7.

    Article  PubMed  Google Scholar 

  184. Cho JJW, Yunker WK, Marck P, Marck PA. Effectiveness of the heat-activated nitinol smart piston stapes prosthesis in stapedectomy surgery. J Otolaryngol Head Neck Surg. 2011;40(1):8–13.

    PubMed  Google Scholar 

  185. Canu G, Lauretani F, Russo FY, et al. Early functional results using the nitibond prosthesis in stapes surgery. Acta Otolaryngol. 2017;137(3):259–64.

    Article  PubMed  Google Scholar 

  186. Heywood RL, Quick ME, Atlas MD. Long-Term Audiometric and Clinical Outcomes Following Stapedectomy With the Shape Memory Nitinol Stapes Prosthesis. Otol Neurotol. 2019;40(2):164–70.

    Article  PubMed  Google Scholar 

  187. Jutila T, Hirvonen TP, Nicoli TK, Vnencak M, Sinkkonen ST. Comparison of manually crimping and laser-activated nitinol prosthesis in otosclerosis surgery: our experience of 98 patients. Clin Otolaryngol. 2017;42(3):728–31.

    Article  CAS  PubMed  Google Scholar 

  188. House WF. Cochlear implants. Ann Otol Rhinol Laryngol. 1976;85:1–93.

    Article  PubMed  Google Scholar 

  189. Güneri EA, Olgun Y. Endoscope-assisted cochlear implantation. Clin Exp Otorhinolaryngol. 2018;11(2):89–95.

    Article  PubMed  Google Scholar 

  190. Orhan KS, Polat B, Celik M, Comoglu S, Guldiken Y. Endoscopic-Assisted Cochlear Implantation: A Case Series. J Int Adv Otol. 2016;12(3):337–40.

    Article  PubMed  Google Scholar 

  191. Poutoglidis A, Fyrmpas G, Vlachtsis K, et al. Role of the endoscope in cochlear implantation: A systematic review. Clin Otolaryngol. 2021.

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Shih, M.C., Liu, YC.C. Review of Transcanal Endoscopic Ear Surgery (TEES) and Bioengineering for Pediatric Otologic Surgery. Curr Otorhinolaryngol Rep 10, 219–230 (2022). https://doi.org/10.1007/s40136-022-00417-2

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