Totally endoscopic tympanic membrane repair.

Transcanal totally endoscopic ear surgery (TEES) has become increasingly popular internationally; however, for surgeons trained with a two-handed microscope-guided approach, the potential challenges of adopting TEES can appear off-putting. This article outlines the pros and cons of TEES for tympanic membrane repair and describes aspects of surgical technique relevant to those who might adopt this approach. Data are provided from the author’s experience along with a review of relevant literature, including several meta-analyses of tympanoplasty outcome. Meta-analyses show that TEES tympanoplasty is as effective at closing tympanic membrane perforations and improving hearing as microscope-guided surgery. Yet patients benefit from avoidance of a skin incision and faster recovery. Repair of the tympanic membrane with TEES is feasible and effective. This minimally invasive approach is very appealing to patients.