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

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.

Chinese abstract

背景：显微镜1型鼓膜成形术（T1T）是慢性中耳炎的经典治疗法。但是, 它有其局限性。耳内窥镜的发展为T1T提供了一个新方法。

目的：探讨内镜T1T与镜下T1T的区别。

材料和方法：回顾性分析了74例行T1T的患者。52例接受了内镜T1T, 22例接受了镜下T1T。参数包括手术时间、切口大小、移植部位, 术后住院时间、视觉模拟量表（VAS）评分、并发症、听力改善和费用比较。

结果：内镜T1T的手术时间（47.0±8.2分钟）比镜下T1T短（58.0±9.3分钟）（p <.05）。内镜T1T的VAS评分（1.5±0.2）低于镜下T1T（5.6±0.4）（p <.05）。内镜T1T无并发症, 但镜下T1T发现对胆管鼓膜神经有损害（1例）。内窥镜（15.0±1.5 dB）和显微T1T（16.0±1.1 dB）之间的听力改善无差异。内镜T1T的术后住院时间较短, 费用较低。

结论和意义：内窥镜T1T是一种微创手术。与显微T1T相比, 其移植物成功率相似, 听力改善相当, 但恢复快, 成本低, 患者满意度高。

Keywords:

• Tympanoplasty
• endoscopic
• microscopic
• complications
• tympanic membrane

Author contributions

Y.Z. and W.W. wrote the paper. Y.Z., K.X., M.H. and W.W. collected and analyzed the data. Y.Z., M.H, Y.M., P.L. and W.W. performed the literature search.

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

This study was supported by Key Clinical Discipline of Tianjin; National Natural Science Foundation of China (81971698) and Tianjin Natural Science Foundation (19JCYBJC27200).