Endoscopic Myringoplasty Versus Microscopic Myringoplasty in Tubotympanic CSOM: A Comparative Study of 120 Cases

Abstract

Myringoplasty is one of the commonest operations performed on the middle ear. Our aim was to compare the results of endoscopic permeatal myringoplasty with that of conventional myringoplasty by post aural approach using operating microscope. A total of 120 patients having central perforation of tympanic membrane were randomly divided into two equal groups of 60 patients each. In the first group, endoscope was used and in the second group microscope was used to do myringoplasty. Temporalis fascia was used as a graft material. The patients were kept in follow-up for 1 year. The pre-operative and post-operative audiograms, post-operative pain, graft uptake and time taken for surgery were compared in both the groups. The graft uptake rate was 91.67% in the endoscopic group, whereas it was 93.3% in the microscopic group. Post-operative pain was significantly less in the endoscopic group as compared with microscopic group and not much difference was found in the gain in A-B gap in either group. The mean ABG gain was 16.16 dB (SD = 4.68) in endoscopic group and 19.54 dB (SD = 3.45) in microscopic group. On applying the Mann-Whitney test, this finding was statistically significant ( value = 0.0001). In our study success rate was equal between endoscopic and microscopic technique. In terms of morbidity and postoperative recovery endoscope produced better results. Endoscopic tympanoplasty can be a good alternative of microscopic tympanoplasty.

Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—A meta‐analysis

“…Our primary search yielded a total of 8700 records. In the screening of the records by title, abstract and full‐text, we found 18 articles which met the eligibility criteria . We found two publications with identical cohorts of patients; therefore, we excluded the recently published one .…”

“…Sixteen studies including 1179 interventions were deemed eligible for inclusion . Accrued results, in which endoscopic type I tympanoplasty was as effective as microscopic type I tympanoplasty in a homogenous dataset, indicated a 90.5% graft uptake rate in the endoscopic and 88.3% success rate in the microscopic group (OR: 1.21, CI: 0.82‐1.77; I 2 = 0.0%, P = 0.910) (Figure ).…”

“…Fifteen authors published data regarding audiological outcomes . We excluded four studies, due to no or insufficient data provided . In the analysis of the postoperative mean ABGs, no statistically significant difference was found (WMD = −1.13; 95% CI: −2.72‐0.45; I 2 = 78.1%, P < 0.001) however, a tendency favouring the endoscopic approach could be observed (Appendix ).…”

“…Six studies analysed the canaloplasty rate, including a total of 594 interventions . The rate of canaloplasty proved eight times higher in the use of the microscope when compared to that of the endoscope (15% vs 0%; OR = 7.96; 95% CI: 4.30‐14.76; I 2 = 0.0%, P = 1.000) (Figure ).…”

“…Twelve studies evaluated data regarding operation time; however, three of these were excluded, due to incomplete reporting . Of these nine studies, six were nRCTs, and an additional three others were RCTs .…”