Endoscopes as an alternative to microscopes for tympanoplasty: a comparative study

Authors

  • Pratik Kumar Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, Delhi, India
  • Joginder Singh Gulia Department of Otorhinolaryngology, Pt B.D Sharma, PGIMS, Rohtak, Haryana, India
  • Nikhil Arora Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, Delhi, India
  • Bhavesh Kumar Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, Delhi, India
  • Parmod Jangra Department of Otorhinolaryngology, Maharaja Agrasen Medical College, Agroha, Haryana, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20242042

Keywords:

Endoscope, Microscope, Tympanoplasty, Mucosal

Abstract

Background: The objective of the study was to evaluate and compare the results of endoscope assisted tympanoplasty with microscope assisted tympanoplasty.

Methods: A prospective comparative study was conducted from January 2020 – September 2021 and included 60 patients of either sex in age group of 18-50 years having unilateral or bilateral inactive (mucosal) chronic otitis media with central perforation. Patients were randomly divided into 2 groups comprising of 30 patients each. Group-A (n=30) patients underwent endoscope assisted tympanoplasty while group-B (n=30) patients underwent microscope assisted tympanoplasty.  

Results: The overall graft take up rate in group-A and group-B was 93.33% and 96.67% respectively. In group-A, graft take-up was 90.90% in grade-IV perforations and 88.89% in grade-V perforations and graft take-up was 100% in grade-II and grade-III perforation. While in group-B, graft take-up was 91.67% for grade-III perforations, and 100% uptake was seen in grade-I, grade-IV and grade-V perforation. In group-A, pre-operative average air bone (AB) gap was 30.95 dB and post operatively it was 14.44 dB with an average hearing gain of 16.55dB while in group-B, the average pre-operative AB gap was 32.81dB and post-operative AB gap was 13.71dB with an average hearing gain of 19.11dB. Mean average time taken in group-A was 79.83±8.78 minutes, while in group-B it was 101.13±11.07 minutes. The average pain assessment score was 4.9 in group-A as compared to a score of 5.4 in group-B.

Conclusions: The results of endoscope assisted and microscope assisted tympanoplasty are comparable. The operating microscope and endoscope should be employed as per the patient’s requirement and surgeon’s expertise.

Metrics

Metrics Loading ...

References

Maroto PD, Gutiérrez JJE, Jiménez MC, Morente JCC, Rodríguez VP, Benítez-Parejo N. Functional results in myringoplasties. Acta Otorrinolaringol Esp. 2010;61:94-9.

Lakpathi G, Reddy LS, Anand. Comparative study of endoscope assisted myringoplasty and microscopic myringoplasty. Indian J Otolaryngol Head Neck Surg. 2016;68:185-90.

Jyothi AC, Srikrishna 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;69:357-62.

Sade J, Berco E, Brown M, Weinberg J, Avraham S. Myringoplasty: short and long- term results in a training program. J Laryngol Otol. 1981;95:635-65.

Olusanya BO, Davis AC, Hoffman HJ. Hearing loss grades and the international classification of functioning, disability and health. Bull World Health Organ. 2019;97:725-8.

Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018;2:088.

Lerut B, Pfammatter A, Moons J, Linder T. Functional correlations of tympanic membrane perforation size. Otol Neurotol. 2012;33:379-86.

Doyle PJ, Schleuning AJ, Echevarria J. Tympanoplasty: should grafts be placed medial or lateral to the tympanic membrane. Laryngoscope. 1972;82:1425-30.

Kartush JM, Elias M, Michaelides EM, Becvarovski Z, LaRouere MJ. Over-underlay myringoplasty. Laryngoscope. 2002;112:802-7.

Doyle PJ. Choice of treatment for chronic suppurative otitis media. J Otolaryngol. 1981;10:245-8.

Maran RK, Jain AK, Haripriya GR, Jain S. Microscopic Versus Endoscopic Myringoplasty: A comparative study. Indian J Otolaryngol Head Neck Surg. 2019;71:1287-91.

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.

Hsu YC, Kuo CL, Huang TC. A retrospective comparative study of endoscopic and microscopic tympanoplasty. J Otolaryngol Head Neck Surg. 2018;47:44.

Pal R, Surana P. Comparative Study Between Microscopic and Endoscopic Tympanoplasty Type I. Indian J Otolaryngol Head Neck Surg. 2019;71:1467-73.

Dogan S, Bayraktar C. Endoscopic tympanoplasty: learning curve for a surgeon already trained in microscopic tympanoplasty. Eur Arch Otorhinolaryngol. 2017;274:1853-8.

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;3:1953-7.

Choi N, Noh Y, Park W, Lee JJ, Yook S, Choi JE, et al. Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty. Clin Exp Otorhinolaryngol. 2017;10:44-9.

Lade H, Choudhary SR, Vashishth A. Endoscopic vs microscopic myringoplasty: a different perspective. Eur Arch Otorhinolaryngol. 2014;271:1897-902.

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

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

Downloads

Published

2024-07-26

Issue

Section

Original Research Articles