Comparison of the Efficacy of Endoscopic Tympanoplasty and Microscopic Tympanoplasty

Abstract

Objective of this study is to compare the endoscopic tympanoplasty (ET) and microscopic tympanoplasty (MT) regarding graft uptake, hearing improvement and cost effectiveness. The total number of patients included in the study was 68 full filling inclusion and external criteria. The total number of patients included in the study was 68, among these 50 were males and 18 were females. Mean age was 44 years. Disease was seen in right ear in 43 patients and in the left ear in 35 patients. The main procedure performed was Tympanoplasty Type 1with underlay technique. Patients were divided into two groups, MT (A) and ET (B), each of this was further divided into Tympanoplasty with Cortical Mastoidectomy (A1, B1) and Tympanoplasty without Cortical Mastoidectomy (A2, B2). Among each type, the graft was either taken from Temporalis Fascia (TF); (A1f, A2f, B1f, B2f) or from the tragal cartilage (TC); (A1c, A2c, B1c, B2c). The success rate was determined by average hearing improvement and graft uptake. According to the results, MT with Cortical Mastoidectomy had success rate of 100% and MT without Cortical Mastoidectomy had success rate of 80% (with TF, the success rate is 75% and with TC, it is 100%). ET with Cortical Mastoidectomy had success rate of 100% and ET without Cortical Mastoidectomy had success rate of 85% (with TC). Total number of patients in which tympanoplasty was done with cortical mastoidectomy (all wet ears) was 46. The results were extraordinary and graft uptake was 100%. Total number of patients who underwent tympanoplasty without cortical mastoidectomy, (all dry ears) was 22. Results were only 81.8%. It was found that patients with ET and TF, were more satisfied with the scar as it became invisible in 2 months. The scar was cosmetically unacceptable in patients having undergone cortical mastoidectomy along with either ET or MT with use of TF graft.