Comparison of endoscopic underlay and microscopic underlay tympanoplasty: a prospective research at a tertiary care centre in Gujarat

Abstract

<p class="abstract"><strong>Background:</strong> Tympanoplasty is an ever evolving surgery with myriad of approaches and tools. Use of endoscope is relatively new and there are few studies evaluating the use of endoscope via microscope because of a big learning curve in using one hand endoscopic technique despite it being minimally invasive.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted from June 2016 to May 2017 with a sample size of 44 patients. The study included patients of Chronic Otitis Media (COM) of mucosal inactive type without any co-morbidities in which only Type-1 tympanoplasty was done. The patients were divided into endoscopic or microscopic group using simple random sampling and after taking written and informed consent. The patient’s details regarding audiometric, oto-endoscopic and nasal endoscopic evaluation were recorded. Intra operative findings, duration of surgery and post-operative pain scoring were recorded. The patients were followed up for 3 months and subjected to post-operative audiometry and patient satisfaction questionnaire. The groups were evaluated for graft take up and closure of air bone gap, post-operative complications and patient satisfaction. The results were analysed using descriptive statistics (mean and percentage) and CHISQ test.</p><p class="abstract"><strong>Results:</strong> Graft was taken up in 21 patients (95%) in microscopic as opposed to 20 in endoscopic group (90%). Mean VAS scoring for pain was 2.5 in microscopic group on first post-operative day and 1.5 for the endoscopic group. The mean improvement in air bone gap post-surgery was 23.68 dB (SD=4.94) for microscopic group and 16.13 dB (SD=6.49) for endoscopic group.</p><p><strong>Conclusions:</strong> Endoscopic tympanoplasty as a technique has a long learning curve. The results indicate that endoscopic technique is as efficacious as and less invasive than microscope surgery for doing tympanoplasty. </p>

Correlation between microscopic and endoscopic approach to tympanoplasty: a comparative study

“…22 Sinha et al noted that the graft uptake was 95% in microscopic tympanoplasty and 90% in endoscopic tympanoplasty which was not significant. 23 The postoperative air bone gap improvement in microscopic group was 23.68 dB and 16.13 dB in endoscopic group which was not significant. 23 93.33% in both endoscopic and microscopic assisted surgeries.…”

“…23 The postoperative air bone gap improvement in microscopic group was 23.68 dB and 16.13 dB in endoscopic group which was not significant. 23 93.33% in both endoscopic and microscopic assisted surgeries. 24 Kumar et al concluded that graft uptake was 86% (26/30) in microscopic myringoplasty and 83% (25/30) in endoscopic myringoplasty.…”

A Comparative Study to Compare the Outcomes of Myringoplasty (Endoscopic Versus Microscopic)

“…[8] Sinha M. et al found that graft was taken up in 21 patients (95%) in microscopic as opposed to 20 in endoscopic group (90%). [9] According to Garcia et al, in terms of surgical outcome at postoperative otoscopy, complete closure of the perforation was observed in 86.4% of patients three months after intervention (endoscopic myringoplasty). [10] In the study conducted by Yadav SPS, 40 out of the 50 patients had an intact tympanic membrane in the eighth postoperative week of endoscopic myringoplasty, accounting for an 80% success rate.…”