How I do it—endoscopic composite cartilage graft tympanoplasty

Tympanic membrane perforations can be challenging depending on their location and on the anatomical characteristics of each individual. Endoscopic ear surgery (EES) offers a number of modifications to the traditional microscopic technique that help overcome those pitfalls. By enhancing the field of view and by carefully adapting a standardized technique and fashioning an ergonomic flap that adapts closely to its surrounding anatomy, outcomes in terms of reduced reperforation rates are satisfactory. Audiological results in the present series are limited, but demonstrate a trend towards improvement of the post-operative pure tone average (P<0.001) and a reduction in the air-bone gap.