Endoscopic versus microscopic type 1 tympanoplasty in chronic suppurative otitis media- tubotympanic type

Authors

  • Kiran A. Deshmukh Department of Otorhinolaryngology, MR Medical College, Sedam Road, Kalaburagi, Karnataka, India
  • Vinayak Kurle Department of Otorhinolaryngology, Grant Govt Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20201289

Keywords:

Endoscope, Microscope, Tympanoplasty, Pure tone audiometry

Abstract

Background: Chronic suppurative otitis media attributes to 71.6% of hearing impairment in which most of them only have central perforations without any ossicular erosion or middle ear pathology. There are insufficient explanations to conclude which technique is better for type 1 tympanoplasty. Hence the study was conducted to compare and analyze the endoscopic technique with conventional microscopic technique for performing type 1 tympanoplasty.

Methods: This prospective study was done at Basaweshwara teaching and general hospital attached to MR medical college, Kalaburagi from December 2015 to June 2017 after obtaining institutional ethical clearance. Patients were selected according to inclusion and exclusion criteria and randomly posted for surgery by either endoscopic or microscopic technique and results were analyzed.  

Results: There were 60 patients in the study between 11-65 years with mean age of 28.85±10.87 years in which were 28 females and 32 were males. All patients were divided into 2 groups in which 30 underwent endoscopic and 30 underwent microscopic type 1 tympanoplasty. In this 46.7% of the patients had left ear conductive hearing loss whereas 31.7% of patients had right ear conductive hearing loss and 21.7% of the patients had bilateral conductive hearing loss which included 22 small perforations, 33 medium size perforations and 5 large perforations of pars tensa.

Conclusions: We conclude that endoscope can be a better alternative for microscope in type 1 tympanoplasty as it provides a wide panoramic view, less operating time and hospital stay with negligible scar post operatively.

Author Biographies

Kiran A. Deshmukh, Department of Otorhinolaryngology, MR Medical College, Sedam Road, Kalaburagi, Karnataka, India

Associate Professor

Dept of otorhinolaryngology

M R Medical College

Gulbarga

Vinayak Kurle, Department of Otorhinolaryngology, Grant Govt Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India

Senior Resident

Dept of Otorhinolaryngology

Grant government medical college & Sir JJ group of hospitals,Mumbai

References

Vikram AK, Vohra A, Maitra A et al, Epidemiology of chronic suppurative otitis media and Deafness in rural area and developing an intervention strategy, Indian J Paediatr. 1995;62(6):725-9.

Saurabh, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular chain status in CSOM in Adults. Indian J Otolaryngol Head Neck Surg. 2010;62(4):421-6.

Storz LA. Myringoplasty with the use of fascia grafts. Arch Otolaryngol. 1961;74:65-9.

Patterson ME, Lockwood RW, Sheehy JL. Temporalis fascia in tympanic membrane grafting. Arch Otolaryngol. 1967;85:73-7.

Huang TY, Ho KY, Wang LF, Chien CY, Wang HM. A Comparative Study of Endoscopic and Microscopic Approach Type 1 Tympanoplasty for Simple Chronic Otitis Media. J Int Adv Otol. 2016;12(1):28-31.

Plinkert P, Leowenheim H. Trends and perspectives in minimally invasive surgery in otorhinolaryngology-head and neck surgery. Laryngoscope. 1997;107(11):1483-9.

Gaurav B, Rashmi G. Hearing Outcome After Type I Tympanoplasty: A Retrospective Study. Indian J Otolaryngol Head Neck Surg. 2015;67(1):39-42.

Parida PK, Nochikattil SK, Surianarayanan G. A Comparative Study of Temporalis Fascia Graft and Vein Graft in Myringoplasty. Indian J Otolaryngol Head Neck Surg. 2013;65(3):569-74.

Mukund MV, Doshi H, Rajput S. An analysis of ear discharge and antimicrobial sensitivity used in its treatment. Int J Res Med Sci. 2016;4(7):2656-60.

Afolabi OA, Salaudeen AG, Ologe FE, Nwabuisi C, Nwawolo CC. Pattern of bacterial isolates in the middle ear discharge of patients with chronic suppurative otitis media in a tertiary hospital in North central Nigeria. African Health Sci. 2012;12(3):362-8.

Wullstien H. Technic and early results of tympanoplasty. Monatsschr Ohrenheilkd Laryng. 1953 87(4):308-11.

Rosenberg SI. Endoscopic otologic surgery. Otolaryngol Clin North Am. 1996;29:291-300.

Yadav SPS, Aggarwal N, Julaha M, Goel A. Endoscope-assisted myringoplasty. Singapore Med J. 2009;50(5):510-2.

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

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

Lakpathi G, Sudarshan RL, Anand. Comparative Study of Endoscope Assisted Myringoplasty and microscopic Myringoplasty. Indian J Otolaryngol Head Neck Surg. 2016;68(2):185-90.

Raj A, Meher R. Endoscopic transcanalmyringoplasty - a study. Indian J Otolaryngol Head Neck Surg. 2001;53:47-9.

Harugop S, Mudhol RS, Godhi RA. A comparative study of endoscope assisted myringoplasty and micrsoscope assisted myringoplasty. Indian J Otolaryngol Head Neck Surg. 2008;60:298-302.

Nayeon C, Yangseop N, Woori P. Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty. Clin Exper Otorhinolaryng. 2017;10(1):44-49.

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

Bhatia K, Vaid L, Taneja HC. Effect of Type 1 Tympanoplasty on the Quality of Life of CSOM Patients. Indian J Otolaryngol Head Neck Surg. 2016;68(4):468-74.

Thirumaran NS, Tripathy SM, Sundaram M, Annapurna. Endoscopic permeatal myringoplasty vs myringoplasty by postaural approach: A comparative study. Nat J Otorhinolaryngol Head Neck Surg. 2015;3:21-3.

Potsangbam DS. Endoscopic Tympanoplasty Type I: Impoving Techniques. Int J Res Med. 2017;5(4): 6-13.

Migirov L, Wolf M. Transcanal microscope-assisted endoscopic myringoplasty in children. Migirov Wolf BMC Pedia. 2015;15:32.

Sade J, Berco E, Brown M, Weinberg J, Avraham S. Myringoplasty short and long-term results in a training program. J Laryngol Otol. 1981;95:653-65.

Glassock ME, Jackson G, Nissen AJ, Schwaber MK. Post auricular undersurface tympanic membrane grafting: a follow up report. Laryngoscope. 1982;92:718-27.

Siraj Z, Mohammad A. Transcanaltympanoplasty: Dura versus temporalis fascia. Ear Noise Throat J. 1992;71:590-2.

Packer P, Kendrick MA, Solar M. What’s best in myringoplasty: underlay or overlay, dura or fascia. J Laryngol Otol. 1982;96:25-41.

Karhuketo TS, Ilomaki JH, Puhakka HJ. Tympanoscope assisted myringoplasty. Otorhinolaryngol. 2001;63:353-8.

Downloads

Published

2020-03-25

Issue

Section

Original Research Articles