Published: 2017-03-25

Merits and demerits of endoscopic tympanoplasty

Kirti P. Ambani, Bhavya B. M., Sanket D. Vakharia, Ankur Khanna, Ashish U. Katarkar


Background: Aim of the study was to evaluate the merits and demerits of endoscopic tympanoplasty compared to conventional microscopic tympanoplasty.

Methods: This prospective comparative study was carried out between October 2015 to September 2016 in our otolaryngology department, for a period of 12 months. Total of 40 patients who fit into inclusion criteria, underwent endoscopic tympanoplasty under local anaesthesia with sedation. All laboratory preoperative testing was done; hearing evaluation was done with audiometry. Postoperative follow up was done at 2nd and 3rd  month’s period, graft status and hearing evaluation with PTA for all four frequencies 500, 1000, 2000 and 4000 Hz with air conduction and bone conduction thresholds were recorded.  

Results: Out of 40 patients, 16 (40%) were males, and 24 (60%) were females, there were 21 (52.5%) cases had moderate perforation, 15 (37.5%) cases had large perforation and 4 (10%) cases had subtotal perforation. Average time taken was of around 1hour and 30minutes, range was (70-140min.). All patients were evaluated for graft status, hearing gain and cosmetic results. Out of 40 patients, 35 (87.5%) patients had successful graft uptake, 2 (5%) patients had graft infection and 3 (7.5%) patients had residual perforation seen postoperatively.

Conclusions: Use of endoscope not only serves as a great teaching tool, but also helps to visualize the middle ear anatomy and pathology intraoperatively with minimal soft tissue manipulation better cosmesis and reduced postoperative morbidity. In our study, we found that endoscopic tympanoplasty had better graft uptake rate.


Rigid Endoscope, Tympanoplasty, Chronic suppurative otitis media, Pure tone audiometry

Full Text:



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

Tarabichi M. Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg. 2010;62(1):6-24.

Kashuketo TS, llomaki JH, Puhakka HJ. Tympanoscope assisted myringoplasty. ORL J Otorhinolaryngol Relat Spec. 2001;63(6):353-8.

Usami S, lijima N, Fujita S, Takumi Y. Endoscopic-Assisted myringoplasty. ORL J Otorhinolaryngol Relat Spec. 2001;63(5):287-90.

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

Herman MK. Tang: The perforated ear-drum: To repair or not? Hong Kong J Online. 1989;11:124-5.

Mathai J. Myringoplasty with temporalis fascia: Analysis of 200 cases. Indian J Otolaryngol Head Neck Surg. 1999;51:9-13.

Singh BJ, Sengupta A, Das SK, Ghosh D, Basak B. A comparative study of different graft materials used in myringoplasty. Indian J Otolaryngol Head Neck Surg. 2009;61:131-4.

Tang Herman MK: The perforated ear-drum: To repair or not? Hong Kong J Online. 1989;11:124-5.

DabholkarJP,Vora K, Sikdar A. Comparative study of ubderlaytympanoplasty with temporalis fascia and tragal perichondrium. Indian J Otolaryngol Head Neck Surg. 2007;59:116-9.

Strahan RW, Acquarelli M, Ward PH, Jafek B. Tympanic membrane grafting. Analysis of materials and techniques. Ann Otol Rhinol Laryngol. 1971;80:854-60.

Gupta N, Mishra RK. Tympanoplasty in children. Indian J Otolaryngol Head Neck Surg. 2002;54:271-3.

Tarabichi M. Endoscopic Middle Ear Surgery. Annals of Otology, Rhinology and Laryngology 1999;108:39-46.

Kashuketo TS, Ilomaki JH, Puhakka HJ. Tympanoscope-Assisted Myringoplasty. Otorhinolaryngology. 2001;63:353-8.

Kozin ED, Lehmann A, Carter M, Hight E, Cohen M, Nakajima HH, et al. Thermal effects of endoscopy in a human temporal bone model: implications for endoscopic ear surgery. Laryngoscope. 2014;124(8):332-9.