A comparative study of endoscopic and microscopic myringoplasty in a rural tertiary care teaching hospital


  • Viswanathan Kavathur Department of ENT, DM Wayanad Institute of Medical Sciences, Kerala, India
  • Vineeth Abraham Anchery Department of ENT, DM Wayanad Institute of Medical Sciences, Kerala, India




CSOM, Endoscopic myringoplasty, Microscopic myringoplasty, Otorrhoea, Otoendoscopy


Background: Myringoplasty is the procedure done to repair the tympanic membrane perforation. In this study we aimed to compare the results of endoscopic myringoplasty and microscopic tympanoplasty.

Methods: A total of 50 patients with central perforation of tympanic membrane and dry ear of minimum 6 months were divided into two groups of 25 each. The even serial numbers were subjected to microscopic myringoplasty through post aural route and odd serial numbers were subjected to endoscopic myringoplasty done through endomeatal route. Both the procedures were done under general anaesthesia. Dried temporalis fascia graft was used and follow up till 1 year post op. Air-bone gap closure, average time taken for surgery, success and failure rates, scar evaluation by doctor and patient along with postoperative return to routine activity were compared. The p value was calculated to find out statistical significance.  

Results: Post operatively the average air-bone gap reduced to 12.6 dB in endoscopic group and 14.28 dB in microscopic group. There was no statistical significant difference in the time taken for both the procedures. There was significant difference in the assessment of postoperative scar and number of days taken for return to routine activity. The success and failure rates of both the procedures were also found to be comparable.

Conclusions: Our study showed that the success rates and average time taken for the procedures were the same for both the techniques but a better cosmetic appeal and considerably fewer days for return to routine activity by the patients who underwent endoscopic procedure.


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

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.

Harugop AS, Mudhol RS, Godhi RA. A comparative study of endoscope assisted myringoplasty and microscope assisted myringoplasty. Indian J Otolaryngol Head Neck Surg. 2008;60:290-302.

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

Raj A, Meher R. Endoscopic transcanal myringoplasty—a study. Indian J Otolaryngol Head Neck Surg. 2001;53(1):47-9.

Glasscock ME, Shambaugh GE. Tympanoplasty. In: Glasscock and Shambaugh, surgery of the ear, 5th edn. Connecticut: People’s Medical Publishing House; 2003: 350-370.

Buckingham RA. Endoscopic otophotography. Laryngoscope. 1963;73:71-4.

EL-Guindy A. Endoscopic transcanal myringoplasty. J Laryngol Otol. 1993;106:493-495.

Mc Kennan KX. Endoscopic second look mastoidoscopy to rule out residual epitympanic—mastoid cholesteatoma. Laryngoscope. 1993;103:810-4.

Kennady DW. Endoscopic sinus surgery. Otolaryngol Clin N Am. 1997;30:313-330.

Fry TL, Newton DF. Otoscopy and photography. Ann Otolaryngol. 1979;88:771-3.

Konrad HR. Paediatric otoscopy and photography of the tympanic membrane. Otolaryngology. 1979;105:431-3.

Patel J, Aiyer RG, Gajjar Y, Gupta R, Raval J, Suthar PP. Endoscopic tympanoplasty vs microscopic tympanoplasty in tubotympanic CSOM: a comparative study of 44 cases. Int J Res Med Sci. 2015;3(8):1953-7.

Tarabichi M. Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol. 1999;108:39-46.

Usami S, Iijima N, Fujita S, Takumi Y. Endoscope-assisted myringoplasty. Otorhinolaryngology. 2001;63:287-90.

Quraishi MS, Jones NS. Day care myringoplasty using tragal perichondrium. Clin Otolaryngol. 1995;20:12-4.

Parelkar K, Nagle S, Jagade M, Thorawade V, Khairnar P, Attakil A, et al. Triple-c cartilage tympanoplasty: case series. Int J Otolaryngol Head Neck Surg. 2015;4:26-31.

Fernandes SV. Composite chondro-perichondrial clip tympanoplasty: the triple-C technique. Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol Head Neck Surg. 2003;128:267-72.

Lela M, Michael W. Minimally invasive transcanal endoscopic ear surgery, endoscopy—innovative uses and emerging technologies. In: Associate Prof. Amornyotin S (ed), InTech. 2015.






Original Research Articles