Comparative study of endoscopic tympanoplasty and conventional tympanoplasty

Priyanka Aggarwal; Barjinder Singh Sohal; J. P. Goyal

doi:10.18203/issn.2454-5929.ijohns20204179

Authors

Priyanka Aggarwal Department of Ear, Nose, Throat and Head and Neck Surgery, Government Medical College, Bharatpur, Rajasthan, India
Barjinder Singh Sohal Department of Ear, Nose, Throat and Head and Neck Surgery, Government Medical College, Patiala, Punjab, India
J. P. Goyal Department of Ear, Nose, Throat and Head and Neck Surgery, Government Medical College, Patiala, Punjab, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20204179

Keywords:

Tympanoplasty, Endoscopy, Microscope, Hearing loss, Graft uptake

Abstract

Background: To compare the results of endoscopic tympanoplasty with that of conventional tympanoplasty and to evaluate and compare the graft uptake in both of these methods. The study was done to evaluate the improvement in hearing after tympanoplasty and the problems faced while doing the endoscope assisted tympanoplasty.

Methods: Between July 2010 to June 2013, 50 patients underwent tympanoplasty, 25 were endoscope assisted (group A) and 25 were microscope assisted (group B). Results of surgery were compared at the end of three and six months post operation.

Results: The success rate in terms of graft uptake rate was 88% with endoscope assisted tympanoplasty and 84% with other microscope assisted tympanoplasty. Overall success rate was 86.0%. Mean hearing improvement was (16.24±10.21 dB) and (14.28±7.10 dB) in group A and group B respectively.

Conclusions: Tympanoplasty with its visualization of hidden corners, justifies tympanoplasty by using endoscope in selected cases with comparable improved results in the literature. Furthermore, the cost of the endoscope is much less (about 10%) in comparision to operating microscope, making it more cost effective in developing countries. However, the endoscope cannot be employed in every case as one hand is blocked. In terms of Patient comfort, the endoscope assisted outnumbers the benefits of other conventional methods.

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Author Biographies

Priyanka Aggarwal, Department of Ear, Nose, Throat and Head and Neck Surgery, Government Medical College, Bharatpur, Rajasthan, India

ASSISTANT PROFESSOR, DEPARTMENT OF EAR, NOSE AND THROAT

Barjinder Singh Sohal, Department of Ear, Nose, Throat and Head and Neck Surgery, Government Medical College, Patiala, Punjab, India

consultant, department of ENT

References

Berthold E. In: Closure of tympanic membrane perforations. Glasscock ME and Shambaugh GE (eds.). Volume 4. Surgery of the Ear, Hamilton, Elsevier India; 1990: 334.

Wullstein H. In: Tympanoplasty. Glasscock ME and Shambaugh GE (eds.). Volume 5. Surgery of the ear, Hamilton, Elsevier India; 2004: 400.

Zollner F. In: Tympanoplasty. Glasscock ME and Shambaugh GE (eds.). Volume 5. Surgery of the ear, Hamilton, Elsevier India; 2004: 400.

Glasscock ME, Shambaugh GE. Endoscope-Assisted Middle Ear Surgery. Volume 5. Surgery of the Ear. Hamilton, Elsevier India; 2003: 325.

Guindy A. Endoscopic transcanal myringoplasty. J Laryngol Otol. 1992;106:493-5.

Pyykkö I, Poe DS, Ishizaki H. Laser-assisted myringoplasty: technical aspects. Acta Otolaryngol Suppl (Stockh). 2000;543:1-4.

Shenoi PM. Management of chronic suppurative otitis media. Volume 5. Scott-Brown’s Otolarngology, London, Butter worth; 1987: 3215-31.

Thomassin JM, Facon F, Gabert K. The effectivity of otoendoscopy in myringoplasty using adipose graft. Ann Otolaryngol Chir Cervicofac. 2004;121(6):346-9.

Glasscock ME. Contraindications to tympanoplasty II: an exercise in clinical judgment. Laryngoscope. 1976;86:70-6.

Awan Z, Bashin H, Hussain A. Myringoplasty: A comparative study of different graft materials and various surgical procedures. Ann Pak Inst Med. 2008;4(4):209-11.

Kontantinidis I, Malliari H, Tsakiropoulou E. Fat myringoplasty as an office based procedure. Otorhinolaryngol-Head and Neck Surgery. 2010;42:25-8.

Klacansky J. How I do it cartilage myringoplasty. Laryngoscope. 2009;119:2175-77.

Usami S, Iijima N, Fujita S, Takumi Y. Endoscope assisted myringoplasty. Journal for Oto-Rhino-Laryngology, Head and Neck Surgery. 2001;63(5): 287-90.

Olusesi AD, Opaluwah E, Hassan SB. Subjective and objective outcomes of tympanoplasty surgery. Eur Arch Otorhinolaryngol. 2011;268(3):367-72.

Demir UL, Karaca S, Basut O. Bone cement or incus interposition in type 2 tympanoplasty: prognostic factors and functional outcomes. Kulak Burun Bogaz Ihtis Derg. 2012;22:299-304.

Dabholkar JP, Vora K, Sikdar A. Comparative study of underlay tympanoplasty with Temporalis fascia and Tragal perichondrium. Indian J of Otolarygol and head and neck sur. 2007;59(2):116-9.

Karhuketo TS, Illomaki JH, Puhakka HJ. Tympanoscope assisted myringoplasty. Journal for Oto-Rhino-Laryngology, Head and Neck Surgery. 2001;63(6):352-8.

Mohindra S, Panda NK. Ear surgery without microscope; is it possible. Indian J Otolaryngol Head Neck Surg. 2010;62(2):138-41.

Slaska Kaspera, Geirek T, Maizel K, Klimczak Golab L. The evaluation of cartilage and perichondrium graft for reconstruction of tympanic membrane. Otolayngol Pol. 2003;57(6):889-92.

Gierek T, Slaska-Kaspera A, Majzel K, Klimczak-Gołab L. Results of myringoplasty and type I tympanoplasty with the use of fascia, cartilage and perichondrium grafts. Otolaryngol Pol. 2004;58(3):529-33.

Somers TH, Houben V, Goovaerts G, Govaerts PJ, Offeciers FE. Histology of the perforated tympanic membrane and its mucoepithelial junction. Clin Otolaryngol Allied Sci. 1997;22:162-6.

Thomassin JM, Facon F, Gabert K. The Effectivity of otoendoscopy in myringoplasty using adipose graft. Ann Otolaryngol Chir Cervicofac. 2004;121(6):346-9.

Kakehata S, Futai K, Sasaki A, Shinkawa H. Endoscopic transtympanic tympanoplasty in the treatment of conductive hearing loss: early results. Otol Neurotol. 2006;27(1):14-9.

Karhuketo TS, Illomaki JH and Puhakka HJ. Tympanoscope-assisted myringoplasty. Journal for oto-rhino-laryngology, head and neck surgery. 2001;63(6):352-8.

Semenov FV, Misiurina IV. Advantages and disadvantages of the application of endoscopic techniques at different stages of tympanoplasty. Vestn Otorinolaringol. 2010;6:48-50.