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Comparative Study Between Post Aural Microscopic and Transcanal Endoscopic Tympanoplasty.

Krishna Medha Kappagantu1, Manish Gupta1

  • 1Department of ENT & Head and Neck Surgery, MMIMSR, MMU, Ambala, Haryana India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|February 6, 2023
PubMed
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Transcanal endoscopic tympanoplasty offers superior outcomes for chronic otitis media compared to microscopic surgery. This minimally invasive approach reduces operative time, pain, and complications while achieving similar hearing gains.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Medical Technology

Background:

  • Chronic otitis media (inactive mucosal disease) often requires surgical intervention for symptom relief, including hearing loss and ear discharge.
  • Postauricular microscopic tympanoplasty is a traditional surgical method, but advancements in optics are driving interest in endoscopic techniques.

Purpose of the Study:

  • To compare the clinical profiles of patients undergoing chronic otitis media surgery.
  • To evaluate and contrast conventional postauricular microscopic tympanoplasty with transcanal endoscopic tympanoplasty regarding key surgical and patient outcomes.

Main Methods:

  • A study involving 60 patients diagnosed with chronic otitis media (inactive mucosal type) over two years.
  • Patients were randomly assigned to two groups: Group A (postauricular microscopic tympanoplasty) and Group B (transcanal endoscopic tympanoplasty).
Keywords:
Comparative studyEndoscopic tympanoplastyMicro-invasive surgeryMicroscopic tympanoplastyOtologyTympanoplasty

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  • Evaluation parameters included operative time, postoperative pain scores, subjective cosmesis, postoperative complications, and postoperative hearing gain (Air-Bone Gap).

    • Main Results:

    • Transcanal endoscopic tympanoplasty demonstrated significantly better outcomes, including reduced intraoperative time, less postoperative pain, and fewer complications.
    • Subjective cosmetic results were also superior with the endoscopic approach.
    • Postoperative hearing gain was comparable between both the microscopic and endoscopic tympanoplasty groups.

    Conclusions:

    • Endoscopic tympanoplasty presents numerous advantages over microscopic tympanoplasty, offering a natural surgical access point and preserving anatomical structures.
    • The technique allows for magnified, wide-angle visualization with minimal tissue manipulation, making it a viable alternative to microscopy.
    • Transcanal endoscopic tympanoplasty is recommended for its improved patient outcomes and cosmetic benefits in treating chronic otitis media.