Comparative Study Between Post Aural Microscopic and Transcanal Endoscopic Tympanoplasty

Chronic otitis media, inactive mucosal disease needs surgical treatment for complete relief from symptoms like hearing loss and discharging ear. There are various surgical approaches mentioned in literature; among which postauricular microscopic tympanoplasty is the most commonly used. With optics advancements, endoscopic surgeries are gaining more popularity due to reduced operative time, less post-operative pain, better cosmesis and reduced hospital stay. To study the clinical profile of patients with chronic otitis media inactive mucosal disease and compare conventional postauricular microscopic tympanoplasty to transcanal endoscopic tympanoplasty on the basis of operative time, postoperative pain, subjective cosmesis, postoperative complications and postoperative hearing gain. 60 patients of chronic otitis media inactive mucosal type, coming in our out-patient department over 2 years and willing to participate were taken for surgery. Patients were divided into 2 groups of 30 each by computerized random technique. Group A underwent conventional postauricular microscopic tympanoplasty and Group B underwent transcanal endoscopic tympanoplasty. Patients were evaluated on the basis of intraoperative time, postoperative pain score, postoperative complications, subjective cosmesis and postoperative hearing gain. Tympanoplasty by transcanal endoscopic approach had better outcomes in terms of less intraoperative time, less postoperative pain, less postoperative complications, and better subjective cosmetic outcome. Postoperative hearing gain (ABG) in both the groups was similar. Endoscopic tympanoplasty has many advantages over microscopic tympanoplasty as it is a natural access point to tympanic membrane and middle ear cleft. It preserves most of normal anatomy by minimizing dissection of bone and soft tissue. It is possible to obtain a wide angle and a magnified view of the operating field using endoscope with minimum manipulation. Therefore endoscope can be a good alternative of microscope for tympanoplasty.