Comparative Study between Microscopic Myringoplasty and Endoscopic Myringoplasty
30 September 2019 (online)
Aim To compare the outcomes of microscope-assisted postauricular approach tympanoplasty using temporalis fascia and endoscope-assisted endomeatal tympanoplasty using tragal perichondrium, among patients with CSOM.
Materials and Methods In 81 patients, group A consisted of 40 patients who underwent endoscopic myringoplasty and group B consisted of 41 patients who underwent the conventional microscopic technique, the outcome was analyzed in terms of the hearing gain, duration of surgery, graft success rate, and to study the comparative benefits of endoscopic tympanoplasty over microscopic tympanoplasty and the outcome of surgical complications, surgical incision, and cosmesis. We also studied the influence of Eustachian tube function on graft uptake.
Results There was no significant difference in hearing gain in both the groups. In group A, out of 40 cases, 36 (90.0%) cases took 1 hour and below while 4 cases took more than 1 (10%) hour, whereas in group B 2 (4.9%) cases took 1 hour or less and 39 (95.1%) cases took more than 1 hour. The p-value was highly significant (p = 0.00). Both case and control groups were evaluated for cosmesis 3 months postoperatively. In group A, out of 40 patients CS was average in 17 (42.5%) patients, good in 5 (12.5%), satisfactory in 17 (42.5%), and poor in 1 (2.5%) patient, whereas in group B out of 41 patients CS was good in 1 (2.4%), satisfactory for 37 (90.2%), and poor in 3 (7.3%) patients. CS was highly significant with a p-value of 0.00.
Conclusion and Clinical Significance The endoscopic and microscopic approaches appear to give equal results in terms of graft uptake. A shorter operative duration and better cosmetic result is an advantage of the endoscopic myringoplasty technique.