Comparison of Microscopic and Endoscopic Myringotomy With or without Grommet

Aims Otitis media with effusion (OME) is a common middle ear condition in younger age group and if medical line of treatment fails, it is treated surgically by myringotomy which is usually done under microscope. As the use of endoscope in ear surgeries has increased in the past decade, we thought of doing myringotomy under endoscope and comparing its advantages and disadvantages over conventional microscopic procedure.

Materials and Methods Design: A time-bound descriptive nonrandomized study. Setting: tertiary care hospital. Patients: 33 children of age group 3 to 13 years suffering with OME, who failed medical treatment were included in the study. Methods:18 underwent myringotomy ± grommet insertion under microscope, and remaining 15 underwent endoscopic procedure.

Results The primary outcome observed was time taken for the procedure which was more in conventional microscope group than that in endoscopic group. Additional observations like visualization of entire tympanic membrane without adjusting patients head and satisfactory clarity of view and depth perception were found to be better in endoscopic group.

Conclusion Less operative time, satisfactory depth perception, satisfactory clarity of field, and visualization of entire tympanic membrane without turning patient's head make myringotomy ± grommet insertion with endoscope a better alternative than with a conventional procedure.

Keywords otitis media with effusion, myringotomy, microscope endoscope