A study to evaluate and compare the outcomes of endoscope versus microscope assisted myringoplasty
Keywords:Chronic suppurative otitis media, Microscopic assisted myringoplasty, Endoscopic assisted myringoplasty
Background: In microscope assisted middle ear procedures surgeons can only observe the parts of the tympanic cavity, the hidden areas, such as the facial recess and sinus tympani, would not be visualised which needs to be exposed for performing tympanoplasty. The aim of the study was to compare the outcomes of microscope versus endoscope assisted myringoplasties in terms of duration of the procedure, graft take up, improvement in hearing and incidence of any complications.
Methods: A prospective comparative study was conducted for a period of one year. A total of 72 patients with CSOM were randomised into two groups of 36 each. Group A patients (n=36) underwent traditional myringoplasty under a microscope and group B patients (n=36) endoscopic assisted myringoplasty was performed. Post-operatively all the patients were followed up for a period of one year. During the follow-up period patients were assessed for the graft take up, hearing improvement, incidence of complications and recurrence rate between the two groups.
Results: Successful graft uptake was observed in 88.8% among patients underwent microscope assisted myringoplasty and it was 94.4% in endoscopic assisted myringoplasty. The mean duration of surgery was 123 mins in microscopic assisted group compared to 92 mins in endoscopic assisted group and the difference was found to be statistically significant. Similarly, the cosmetic results and the post-operative pain were more favorable for endoscopic assisted group than microscopic assisted group and the difference was found to be statistically significant.
Conclusions: Enoscopic assisted procedure could be considered as a better alternative for microscopic assisted myringoplasty.
Kumaria MS, Madhavi J, Bala N, Raja KK, Jyothy MA. Prevalence and associated risk factors of otitis media and its subtypes in south Indian population. Egypt J Ear Nose Throat Allied Sci.2016;17(2):57-62.
Li WC, Chiu NC, Hsu CH, Lee KS, Hwang HK, Huang FY. Pathogens in the middle ear effusion of children with persistent otitis media: implications of drug resistance and complications J Microbiol Immunol Infect. 2001;34:190-4.
Dhooge IJ. Risk factors for the development of otitis media. Curr Allergy Asthma Rep. 2003;3:321-5.
Harugop AS, Mudhol RS, Godhi RA. A comparative study of endoscope assisted myringoplasty and micrsoscope assisted myringoplasty. Indian J Otolaryngol Head Neck Surg. 2008;60(4):298-302.
Thomassin JM, Korchia D, Doris JMD. Endoscopic-guided otosurgery in the prevention of residual cholesteatomas. Laryngoscope 1993;103(8):939-43.
Li B, Zhou L, Wang M, Wang Y, Zou J. Endoscopic versus microscopic surgery for treatment of middle ear Cholesteatoma: a systematic review and metaanalysis, Am J Otolaryngol Head Neck Med Surg. 2020;42(2):102451.
Ayache S. Otoendoscopy in cholesteatoma surgery of the middle ear: what benefits can be expected? Otol Neurotol. 2008;29(8):1085-90.
Badr-el-Dine M. Value of ear endoscopy in cholesteatoma surgery. Otol Neurotol. 2002;23(5):631-5.
Kumral TL, Uyar Y, Yıldırım G, Berkiten G, Mutlu AT, Kılıç MV. Does endoscopic surgery reduce recurrence of the petrous apex cholesteatoma? Indian J Otolaryngol Head Neck Surg. 2013;65(4):327-32.
Gaur RS, Tejavath P, Chandel S. Comparative study of microscopic‑assisted and endoscopic‑assisted myringoplasty. Indian J Otol. 2016;22(3):177-82.
Jyothi AC, Shrikrishna BH, Kulkarni NH, Kumar A. Endoscopic myringoplasty versus microscopic myringoplasty in tubotympanic csom: a comparative study of 120 cases. Indian J Otolaryngol Head Neck Surg. 2017;69(3):357-62.
El-Guindy A. Endoscopic transcanal myringoplasty. J Laryngol Otol. 1992;106(6):493-5.
Kaur M, Singh B, Verma BS, Kaur G, Kataria G, et al. Comparative evaluation between tympanoplasty alone & tympanoplasty combined with cortical mastoidectomy in non-cholesteatomatous chronic suppurative otitis media in patients with sclerotic bone. IOSR J Dental Med Sci. 2014;13(6):40-5.
Varshney S, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular status in chronic suppurative otitis media in adults, Indian J Otolaryngol Head Neck Surg. 2010;62(4):421-6.
Lasini AO, Afolabi AO. Mastoid surgery for chronic ear : a ten year review. J Head Neck Surg. 2008;2(2):41.
Harugop AS, Mudhol RS, Godhi A. Comparative study of endoscope assisted myringoplasty and microscope assisted myringoplasty. Ind J Otolaryngol Head Neck Surg. 2008;60(4):298-302.
Lakpathi G, Reddy S, Anand SL. Comparative study of endoscope assisted myringoplasty and microscopic myringoplasty. Indian J Otolaryngol Head Neck Surg. 2016;68(2):185-90.
Kumar M, Kanaujia SK, Singh A. A comparative study of endoscopic myringoplasty vs conventional myringoplasty. Int J Otorhinolaryngol Clin. 2015;7(3):132-7.
Shoeb M, Gite V, Bhargava S, Mhashal S. Comparison of surgical outcomes of tympanoplasty assisted by conventional microscopic method and endoscopic method. Int J Otorhinolaryngol Head Neck Surg. 2016;2:184-8.
Raj A, Meher R. Endoscopic transcanal myringoplasty: a study. Indian J Otolaryngol Head Neck Surg. 2001;53:47-9.
Gadag R. Comparative study of outcomes of microscopic versus endoscopic myringoplasty. Medica Innovatica. 2016;5(1):3-6.
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.
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.