A comparative study of endoscopic assisted versus conventional middle ear and mastoid surgery at a tertiary care teaching hospital

Authors

  • Jitendra Kumar Sharma Department of Otorhinolaryngology, Tata Memorial Hospital, HBNI, Mumbai, Maharashtra, India
  • Sushma Mahich Department of Otorhinolaryngology, CHC, Pushkar, Ajmer, Rajasthan, India
  • Navneet Mathur Department of Otorhinolaryngology, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20214823

Keywords:

Air-bone gap, Cholesteatoma, Endoscopic, Tympanoplasty, Mastoidectomy

Abstract

Background: Objectives were to compare outcomes, intra operative visualization and operative time duration in endoscopic assisted vs conventional middle ear and mastoid surgery.

Methods: This prospective comparative study was conducted in 50 patients; among them 25 cases were of endoscope assisted middle ear surgery and 25 cases with conventional microscopic middle ear surgery. A 4 mm diameter, 18 cm long rigid, zero-degree endoscope and operating microscope was used. Primary outcomes include mean average pre and post operative air-bone (A-B) gap, hearing thresholds, intra operative visualization and duration of surgery.

Results: Mean A-B gap closure for endoscopic assisted tympanoplasty was 12.76±6.00 dB, while it was 8.38±5.78 dB for non-endoscopic assisted tympanoplasty. The results were comparative. Mean intra-operative time duration for endoscopic assisted tympanoplasty was 70.23±4.17 min, while it was 77±9.80 min for non-endoscopic assisted tympanoplasty with statically significant difference between both groups (p=0.03). Graft uptake rate for endoscopic assisted tympanoplasty was 92.31% while it was 84.62% for non-endoscopic assisted tympanoplasty. Residual cholesteatoma remnant on endoscopy was found in 43.66% cases out of 12 mastoidectomy cases performed via endoscopic assistance.

Conclusions: The endoscope can be successfully applied to ear surgery for most of the ear procedures with a reasonable success rate both in terms of perforation closure and hearing improvement and with minimal exposure. Wide-field zero, 30 or 70° endoscope sallow visualization of hidden anatomic spaces and working around corners i.e., epitympanum, hypotympanum and retro tympanum for safe removal of cholesteatoma.

Author Biographies

Jitendra Kumar Sharma, Department of Otorhinolaryngology, Tata Memorial Hospital, HBNI, Mumbai, Maharashtra, India

Senior Resident, Department of Otorhinolaryngology,

Sushma Mahich, Department of Otorhinolaryngology, CHC, Pushkar, Ajmer, Rajasthan, India

Medical Officer,
Department of Otorhinolaryngology,

Navneet Mathur, Department of Otorhinolaryngology, RNT Medical College, Udaipur, Rajasthan, India

Professor & Head, Department of Otorhinolaryngology,

References

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Published

2021-12-23

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Section

Original Research Articles