Background: Terminologically, the surgery for chronic otitis media (COM) called tympanoplasty indicates both the cleaning of the active disease or sequela within the tympanic cavity and hearing reconstruction by tympanic membrane repair and ossicular chain reconstruction. Three surgical approaches, namely retroauricular, endaural, and transcanal, were described as surgical methods under a microscope. In the literature, although there is much information and data about the retroauricular and endaural approaches, the documentation and data about the transcanal approach is very limited.
Methods: Microscopic transcanal tympanoplasty has been performed on 1095 cases of which the indications were COM, sequela of COM, and cholesteatoma limited to epitympanum since 2009. In cases without su!cient exposure of the anterior tympanic annulus, a retroauricular approach (15 cases) was performed. Tragal cartilage, temporalis fascia, and fat tissue were used as a graft materials.
Results: Myringoplasty was performed in 11 patients, type 1 tympanoplasty in 665 cases, type 2 tympanoplasty in 278 cases, type 3 in 121 cases, and type 4 in 5 cases. Graft intake ratio was 89.2% (970 cases) of the 1080 cases who were followed up. Graft intake was unsuccessful on 110 cases (10.8%). Of 36 cholesteatoma cases, recurrence was seen only in 2 cases (5.5%).
Conclusion: Microscopic transcanal approach for tympanoplasty is suitable in majority of cases. It leads to shorter operation times and faster postoperative healing period. However, it "rst requires to dominate the surgical anatomy of the temporal bone in detail. This can be obtained by dissections on cadavers, and further it necessitates experience with otologic surgery by retroauricular approaches.
Cite this article as: Aslan A. Microscopic transcanal approach for tympanoplasty. Balkan ORL-HNS 2025;2(1):10-14.