Transcanal Microscopic vs Endoscopic Type I Tympanoplasty in Dry Central Perforation: A Comparative Retrospective Study
Ravneet R Verma, Ravinder Verma
Citation Information :
Verma RR, Verma R. Transcanal Microscopic vs Endoscopic Type I Tympanoplasty in Dry Central Perforation: A Comparative Retrospective Study. Int J Otorhinolaryngol Clin 2021; 13 (1):7-10.
Introduction: Type I tympanoplasty or myringoplasty is the repair of the perforated eardrum. Comparisons of microscopic and endoscopic techniques present in the literature use different routes of access and cannot be compared head-on.
Objective: To compare endoscopic and microscopic myringoplasty results when both are performed via the transcanal route.
Methods: We present a retrospective study done at a single center to compare endoscopic and microscopic type I tympanoplasties both done via the transcanal route. A total of 70 patients, 30 operated with endoscope and 40 with microscope, were included in the analysis. Patients of either sex, between 18 and 60 years of age, with a dry perforation and air-bone gap (ABG) of ≤30 dB, were included.
Results: Perforations were completely closed in 93% of the endoscopic group and 92.5% of the microscopic group. The ABG closure was 12.89 dB in endoscopic and 11.97 dB in the microscopic groups. There was no association of the site or size of perforation with failure of surgery. The time taken for surgery was also equivalent. The endoscope had the advantage of avoiding a canaloplasty and looking into the hidden areas of the middle ear.
Conclusion: For transcanal, minimally invasive type I tympanoplasty, both techniques provide equivalent results. We recommend the use of an endoscope as the primary or an accessory tool for better visualization.
McKennan KX. Endoscopic “second look” mastoidoscopy to rule out residual epitympanic/mastoid cholesteatoma. Laryngoscope 1993;103(7):810–814. DOI: 10.1288/00005537-199307000-00016.
Thomassin JM, Korchia D, Doris JM. Endoscopic-guided otosurgery in the prevention of residual cholesteatomas. Laryngoscope 1993;103(8):939–943. DOI: 10.1288/00005537-199308000-00021.
Harugop AS, Mudhol RS, Godhi RA. A comparative study of endoscope assisted myringoplasty and microscope assisted myringoplasty. Indian J Otolaryngol Head Neck Surg 2008;60(4):298–302. DOI: 10.1007/s12070-008-0099-5.
Lade H, Choudhary SR, Vashishth A. Endoscopic vs microscopic myringoplasty: a different perspective. Eur Arch Otorhinolaryngol 2014;271(7):1897–1902. DOI: 10.1007/s00405-013-2673-z.
Jyothi AC, Shrikrishna BH, Kulkarni NH, et al. Endoscopic myringoplasty versus microscopic myringoplasty in tubotympanic CSOM: a comparative study of 120 cases. Indian J Otolaryngol Head Neck Surg 2017;69(3):357–362. DOI: 10.1007/s12070-017-1147-9.
Plodpai, Y, Paje, N. The outcomes of overlay myringoplasty: endoscopic versus microscopic approach. Am J Otolaryngol 2017;38(5):542–546. DOI: 10.1016/j.amjoto.2017.05.007.
Kozin ED, Gulati S, Kaplan AB, et al. Systematic review of outcomes following observational and operative endoscopic middle ear surgery. Laryngoscope 2015;125(5):1205–1214. DOI: 10.1002/lary.25048.
Maran RK, Jain AK, Karipriya GR, et al. Microscopic versus endoscopic myringoplasty: a comparative study. Indian J Otolaryngol Head Neck Surg 2019;71(Suppl. 2):1287–1291. DOI: 10.1007/s12070-018-1341-4.
Dundar R, Kulduk E, Soy FK, et al. Endoscopic versus microscopic approach to type I tympanoplasty in children. Int J Pediatr Otorhinolaryngol 2014;78(7):1084–1089. DOI: 10.1016/j.ijporl. 2014.04.013.
Ohki M, Kikuchi S, Tanaka S. Endoscopic type-1 tympanoplasty in chronic otitis media: comparative study with a postauricular microscopic approach. Otolaryngol Head Neck Surg 2019;161(2): 315–323. DOI: 10.1177/0194599819838778.
Pap I, Tóth I, Gede N, et al. Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive: a meta-analysis. Clin Otolaryngol 2019;44(6):942–953. DOI: 10.1111/coa.13407.