COMPARATIVE ASSESSMENT OF SURGICAL OUTCOMES OF MICROSCOPIC TYMPANOPLASTY TO MINIMALLY INVASIVE ENDOSCOPIC TYMPANOPLASTY

Abstract

Background: CSOM (chronic suppurative otitis media) is a disease having high prevalence globally including India and
usually affect subjects from low socio-economic background. It is treated with tympanoplasty where Hopkins Karl Storz
Endoscope 0°, 30°, 2.7mm 18 cm and Carl Zeiss Opmi Surgical ENT Microscope has been used for performing ear
surgeries owing to their cost-effectiveness, portability, and better optics.
Aim: The present study aimed to comparatively assess the surgical outcomes following microscopic tympanoplasty and
invasive endoscopic tympanoplasty.
Methods: The present study assessed 120 subjects who underwent tympanoplasty in the institute. 120 subjects were
randomly and equally divided into two groups namely the microscopic group and endoscopic group. For all the subjects,
demographics, tympanic membrane perforation size, and pure-tone audiometry were assessed preoperatively and 8th week
postoperatively. Also, graft uptake rate, postoperative morbidity, average surgical time, and anesthesia type were assessed
in both groups.
Results: A graft uptake rate of 96% and 93% were respectively seen in the microscopic and endoscopic groups. Higher
postoperative morbidity was seen in the microscopic group compared to the endoscopic group, whereas; mean surgical time
was lesser in the endoscopic group. Endoscopic tympanoplasty was more economical and was done under local anesthesia.
The mean air-bone gap was 16.05dB and 16.42 dB respectively in the microscopic and endoscopic group.
Conclusions: Minimally invasive endoscopic technique has equal graft uptake and hearing gain compared to conventional
microscopic tympanoplasty with the benefit of less medical resource consumption and less postoperative morbidity making
it easy to perform and cost-effective.