Day-case Truly Scarless Endoscopic Tympanoplasty(TSET) with synthetic tissue graft in pediatric patients over 10 years old.

[BACKGROUND] to evaluate the success of Truly Scarless Endoscopic Tympanoplasty type 1 (TSET) in pediatric patients with the use of synthetic graft.

[METHODS] prospective study.

[RESULTS] during a 6 year period 12 children underwent TSET using four layered tissue graft (Biodesign, Cook medical). This was a strictly endoscopic procedure with an underlay technique. No conversion to microscopic surgery was deemed necessary and no incision outside the ear canal was made, hence the term Truly Scarless Endoscopic Tympanoplasty (TSET) procedure. Operative time ranged from 40 min to 130 min. There were 11 boys and 1 girl aged 11-16 years. All patients were discharged on the same day with no bandage and just a cotton wool in the ear canal. All grafts survived except one who ended with a microperforation (8,3 %) that did not require futher surgery. The failed case was one of a total perforation with was a revision case from another institution and throughout the operation had persistent hypertension and a less than ideal operative field. Follow up of all 12 patients ranged from 12 to 60 months.

[CONCLUSIONS] TSET using synthetic material is an excellent alternative to classic pediatric tympanoplasty type I, it is painless, patients leave theatre with just a cotton wool in their ear canal, are discharged with no bandage, stitches or scars and is ideal for a day-case procedure. Success rates and graft failures are equivalent to classic ear microsurgery.