Bikash Shrestha - Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
Ashish Dhakal - Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
Aakash Pradhan - Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
Monika Pokharel - Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
Pradeep Rajbhandari - Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
Abha KC - Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
Krishna Shrestha - Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.

Introduction: The use of the endoscope in otological surgeries has both diagnostic and therapeutic values. It provides an excellent view in difficult nooks and corners. The use of endoscopic sandwich myringoplasty using cartilage and perichondrium has its benefit in hearing outcome and graft uptake in long-term follow-up. The main objective was to compare the long-term with short- term hearing outcomes in those who have undergone endoscopic sandwich myringoplasty with Dhulikhel hospital (D‑HOS) technique. Materials and Methods: Forty-two patients who underwent endoscopic sandwich myringoplasty with D-HOS technique using tragal cartilage perichondrium were enrolled in the study. The hearing outcome was analyzed by comparing the pre-operative findings  with post-operative findings and amongst post-operative patients, long-term with short-term  air bone gap (ABG) and ABG closure in speech frequencies (۰.۵kHz, ۱kHz, ۲kHz, ۴kHz) were compared. Results: Amongst forty-two patients, ۴۰ (۹۵.۲%) had graft uptake in both short-term (۶.۰۸ months) and in long-term (۲۰ months) follow-up. The mean pre-operative ABG was ۲۸.۱±۹.۳dB whereas the mean short-term post-operative ABG was ۱۴.۵±۷.۲dB, it showed statistical significance (P=۰.۰۰۱). Likewise, while comparing pre-operative with long-term post-operative ABG (۱۳.۴±۴.۸ dB), it showed statistical significance of P=۰.۰۰۰. While comparing short-term with long-term post-operative ABG, it did not show any statistical significance (P=۰.۰۶۵).The mean closure in ABG in both short-term and long-term hearing assessment was not statistically significant (P=۰.۰۷۷). Conclusion: Endoscopic sandwich myringoplasty with D-HOS technique is a reliable procedure with good hearing outcome and graft uptake in both short and long-term follow-up.

Air bone gap, Endoscopy, Myringoplasty, Perichondrium, Tragal cartilage graft