Comparison of clinical outcome between endoscopic and postauricular incision microscopic type-1 tympanoplasty

Acta Otolaryngol. 2021 Jan;141(1):29-33. doi: 10.1080/00016489.2020.1821091. Epub 2020 Oct 6.

Abstract

Background: Microscopic type-1 tympanoplasty (T1T) is a classical method for the treatment of chronic otitis media. However, it has its limitations. The development of otoendoscopy provided a new method for T1T.

Objective: To investigate the difference between endoscopic T1T and microscopic T1T.

Material and methods: Seventy-four patients who underwent T1T were evaluated retrospectively. About 52 cases underwent endoscopic T1T, and 22 cases accepted microscopic T1T. Parameters including operative duration, incision size, graft site, duration of postoperative hospitalization, visual analog scale (VAS) score, complications, hearing improvement, and expenses were compared.

Results: Operative duration of endoscopic T1T (47.0 ± 8.2 min) was shorter than microscopic T1T (58.0 ± 9.3 min) (p < .05). The VAS score under endoscopic T1T (1.5 ± 0.2) was lower than microscopic T1T (5.6 ± 0.4) (p < .05). There was no complication during endoscopic T1T, but damage to the chorda tympani nerve (one case) was noted for microscopic T1T. There was no difference in hearing improvement between endoscopic (15.0 ± 1.5 dB) and microscopic T1T (16.0 ± 1.1 dB). Duration of postoperative hospitalization and expenses were lower for endoscopic T1T.

Conclusions and significance: Endoscopic T1T is a minimally invasive surgery with similar graft success rate, comparable hearing improvement, fast recovery, low cost, and high patient satisfaction compared to microscopic T1T.

Keywords: Tympanoplasty; complications; endoscopic; microscopic; tympanic membrane.

Publication types

  • Comparative Study

MeSH terms

  • Chronic Disease
  • Ear Auricle
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Otitis Media / surgery*
  • Otoscopy / methods*
  • Retrospective Studies
  • Treatment Outcome
  • Tympanic Membrane / surgery*
  • Tympanoplasty / methods*