Comparison of Endoscopic Versus Microscopic Tympanoplasty

Introduction:Tympanoplasty is a common surgery for chronic otitis media and has conventionally been performed with a microscope for decades. The trend of endoscopic minimally invasive surgeries has been increasing worldwide for the last few decades. Few studies have discussed the outcomes of microscopic and endoscopic tympanoplasty. This study aims to compare results of tympanoplasty done with microscope vs endoscope in terms of graft take rate and improvement in conductive hearing loss.Materials and Methods:We did a retrospective review of ۱۲۰ patients (۵۴ male and ۶۶ female) who underwent Type I tym­panoplasty at Liaquat National Postgraduate Medical Center from January ۲۰۱۹ to January ۲۰۲۰. We included ۶۰ patients who underwent microscopic tympanoplasty and ۶۰ patients who underwent endoscopic tympanoplasty. Postoperative graft uptake and hearing improvement were studied. Results:Overall mean preoperative hearing loss was ۳۰.۲۴ (±۹.۶۱) dB as compared to mean postoperative hearing loss, which was reduced to ۱۹.۳۶ ( ±۸.۵۴) dB, and the difference was significant (P-value <۰.۰۰۱. No statistically significant difference was found for air-bone gap closure between the two groups (P-value ۰.۷۸). Out of ۱۲۰ patients, overall successful graft uptake was seen in ۱۰۹ (۹۰.۸%). In microscopic tympanoplasty, graft take was ۹۰.۰%, compared to ۹۱.۶% in endoscopic patients. There was no significant difference in graft take in the two groups.Conclusions:The endoscopic tympanoplasty is comparable to microscopic in terms of graft uptake and hearing improvement.