title: Double-handed endoscopic myringoplasty with a holding system in children: Preliminary observations.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatric Otorhinolaryngology, University of Bescia, Brescia, Italy.
authors.forename: L O Redaelli
authors.initials: LO
authors.lastname: De Zinis
authors.affiliation: Department of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Berlucchi
authors.affiliation: Department of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy. Electronic address: nadernassif@alice.it.
authors.forename: N
authors.initials: N
authors.lastname: Nassif
mesh_terms: D000293:Adolescent; D002648:Child; D004432:Ear, Middle; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009225:Myringoplasty / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*; D018058:Tympanic Membrane Perforation / Q000601:surgery*
keywords: Hearing; Holder; Myringoplasty; Pediatric otology; Surgical otology