Endoscopic versus microscopic type-I cartilage tympanoplasty for anterior perforation – a comparative study

Abstract

Background

Chronic otitis media with anterior perforation is a challenging condition to treat with a microscope especially if the canal is narrow or has overhang. The endoscope provides the advantage of wide-angle view and transcanal access avoiding postauricular approach and canaloplasty.

Objective

To compare the anatomical, functional outcomes, and surgical duration between endoscopic and microscopic type-I tympanoplasty performed for anterior perforation.

Materials and methods

A comparative study was conducted. The two groups, the microscopic (MT) and the endoscopic (ET) were created with 50 cases each and underwent type-I tympanoplasty. Results were evaluated at a minimum follow-up of 12 months.

Results

The graft uptake rate in MT and ET was 81.8% and 91.3% respectively and was not statistically significant. The mean operative time for MT and ET was 68.68 ± 18.79 min and 61.24 ± 11.18 min respectively which was significant (p-.003). Endoscopic tympanoplasty significantly saved time. The difference in hearing outcomes was highly significant within the groups but not between the groups.

Conclusion and significance

The endoscopic tympanoplasty offered superior visualization avoiding postauricular incision and canaloplasty, with morphological and functional outcomes comparable to microscopic tympanoplasty. It offers significantly faster completion of procedure and provides minimally invasive surgery.

Chinese abstract

背景：慢性中耳炎伴前部穿孔是一种用显微镜很难治的疾病, 尤其是在耳道狭窄或有悬垂的情况下。内窥镜提供了广角视和经耳道接近的优势, 避免了耳后入路和耳道成形术。

目的：比较内镜和镜下I型鼓室成形术治疗前穿孔的解剖、功能结果和手术时间。

材料和方法：进行了比较研究。显微镜组（MT）和内窥镜组（ET）各有50哥病例,

都进行了I型鼓膜成形术。在至少12个月的随访中评估结果。

结果：MT组和ET组的移植物摄取率分别为81.8％和91.3％, 差异无统计学意义。MT组和ET组的平均手术时间分别为68.68±18.79分钟和61.24±11.18分钟, 差异显著（p-.003）。内窥镜鼓室成形术大大节省了时间。两组之间的听力结果差异非常显著, 而各组内病例之间则没有显著差异。

结论和意义：内窥镜鼓室成形术提供了高可视性, 避免了耳后切口和耳道成形术, 其形态和功能结果可与显微镜鼓室成形术相比。它大大加快了手术过程, 并提供了微创手术。

Keywords:

• Tympanoplasty
• anterior perforation
• cartilage
• endoscope
• microscope

Disclosure statement

No potential conflict of interest was reported by the author(s).