Microscopic Tympanoplasty Versus Endoscopic Tympanoplasty: A Comparative Study in a Tertiary Care Centre of West Bengal

Abstract

BACKGROUND Chronic otitis media is one of the most common health problems of our country. Perforation in their tympanic membrane and hearing loss are the presenting feature of chronic otitis media. Reconstruction of the hearing mechanism can be done by surgical procedure namely tympanoplasty. This study is being conducted to compare the success rate of tympanoplasty regarding graft uptake, hearing improvement and also to assess the advantage and disadvantage of endoscope and microscope during surgery. MATERIALS AND METHODS This randomized prospective study was conducted in Malda Medical College between August 2015 to July 2018. In this study, 60 patients of chronic otitis media with dry perforation for at-least 3 weeks, in the age group 16-49 years were divided into two equal groups of 30 each. First group underwent type 1 tympanoplasty by microscope and another group underwent type 1 tympanoplasty by endoscope. Data was collected from above patients and statistically analysed regarding graft taken or rejected and hearing improvement. RESULTS This study included 60 patients, 30 patients in each group. Success rate regarding the drum closure in endoscopic group is 86.66%, whereas in microscopic group it was 83.33%. Post-operative A-B gap improvement is also little better in endoscopic group than microscopic group. In endoscopic technique, one patient had medialisation of graft postoperatively. We got one case of medialisation and another case of lateralisation of graft in microscopic method postoperatively. CONCLUSION Endoscope is better for closure of perforated tympanic membrane than microscope because of better field of vision.

Hearing assessment and status of tympanic membrane pre and post-operated tympanoplasty in cases of CSOM.

“…12 A study published recently in 2019 revealed that graft success rate in endoscopic tympanoplasty is 86.66% whereas in microscopic tympanoplasty, it was 83.33%. 13 Another study reported that pre-operated mean air conduction was 53.22 + 12.24dB, post-operated mean air conduction was 39.11 + 19.93dB and post-operated AB-gap decreased by 8.68dB. 14 this study also co relate with our study.…”