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Is office‐based myringoplasty a suitable alternative to surgical tympanoplasty?

LITERATURE REVIEW A literature review was performed in PubMed from January 1, 1900 to January 1, 2013. There were 4,969 studies identified using the search terms “tympanoplasty” or “myringoplasty.” Only papers in English were reviewed. To avoid confusion in the nomenclature, we define office-based myringoplasty as a transcanal procedure performed without sedation or general anesthesia and without creating a tympanomeatal flap. The best available techniques, in terms of closure rates, were chosen for comparison. If hearing results are available, they are discussed. Unfortunately, the lack of reporting in the literature makes comparisons on hearing results difficult. In contrast, a surgical tympanoplasty is the standard procedure used by most otolaryngologists, using a postauricular incision, and a tympanomeatal flap is elevated. Standard tympanoplasty techniques adapted for use in the office, or techniques currently under clinical investigation or not yet approved by the US Food and Drug Administration (FDA) were not included in this review. The following techniques involve substances all approved by the FDA, although they are off-label uses.