The Efficacy of Endoscopic Exploratory Tympanotomy in Conductive Hearing Loss Patients

Abstract

Objectives. This study aimed to compare the outcome of endoscopic and microscopic tympanoplasty.Methods. This was a retrospective comparative study of 73 patients (35 males and 38 females) who underwent type I tympanoplasty at Samsung Medical Center from April to December 2014. The subjects were classified into two groups; endoscopic tympanoplasty (ET, n=25), microscopic tympanoplasty (MT, n=48). Demographic data, perforation size of tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3 months postoperatively, operation time, sequential postoperative pain scale (NRS-11), and graft success rate were evaluated.Results. The perforation size of the tympanic membrane in ET and MT group was 25.3%±11.7% and 20.1%±11.9%, respectively (P =0.074). Mean operation time of MT (88.9±28.5 minutes) was longer than that of the ET (68.2±22.1 minutes) with a statistical significance (P =0.002). External auditory canal (EAC) width was shorter in the ET group than in the MT group (P =0.011). However, EAC widening was not necessary in the ET group and was performed in 33.3% of patients in the MT group. Graft success rate in the ET and MT group were 100% and 95.8%, respectively; the values were not significantly different (P =0.304). Pre-and postoperative audiometric results including bone and air conduction thresholds and air-bone gap were not significantly different between the groups. In all groups, the postoperative air-bone gap was significantly improved compared to the preoperative air-bone gap. Immediate postoperative pain was similar between the groups. However, pain of 1 day after surgery was significantly less in the ET group. Conclusion.With endoscopic system, minimal invasive tympanoplasty can be possible with similar graft success rate and less pain.

Safety and Effectiveness of Endoscopic Ear Surgery: Systematic Review

“…으로 수술을 시행한 연구 25,26,30,38,77) 로 청력개선 정도는 수술 전후 기도골도청력차이 변화량은 2편 25,77) 에서 군 간 유의한 차이를 보이지 않았으며, 수술 후 기도골도청력차이에 대한 범주별 환자수 비율은 0~10 dB의 경우 3편 26,30,38) 에서 중재 군이 비교군에 비해 환자 비율이 높은 반면 21~30 dB인 경 우는 2편 26,30) 에서 중재군이 비교군에 비해 낮았으며 나머지 1편 38) 은 중재군이 비교군에 비해 높게 보고되었다(Table 3). www.kjorl.org 375 와 유사하거나 내시경을 이용한 경우가 더 낮게 보고되었다.…”

“…www.kjorl.org 375 와 유사하거나 내시경을 이용한 경우가 더 낮게 보고되었다. 20,21,23,25,26,28,30,32,35,38) 일부 연구에서 안면신경 손상 30,31,33,38,46,60,62) 이나 외림프액 분출 [20][21][22][23][24][25]27,28,32,36,39,77,78,80) 진주종 잔존률 및 재발률에서 유의한 차이가 없었다. 17,31,34,37,79) 대부분의 유효성 결과가 현미경 수술과 비교 시 통계적으로 유의한 차이를 보이지는 않았지만, 고막생착, 진주종 제거 및 청력개선에 있어 더 나은 결과를 보이는 경향이 있으며, 기술 편, 31,34,36,79,80) 증례연구 및 증례보고 10편 7,40,41,43,45,52,53,[56][57][58] )으 로, 연구대상의 연령에 소아(4~1...…”

Transcanal Endoscopic Tympanoplasty for Pediatric Patients Under 15 Years of Age With Chronic Otitis Media

“…Initially, surgeons who were more used to microscopic manipulation felt uncomfortable in avoiding the use of endoscopy. However, numerous reports have been published on the use of endoscopy and the interest and importance of the endoscopic middle ear surgery have been revealed [2][3][4][5].…”