Endoscopic and Microscopic Tympanoplasty for Adhesive Otitis Media: A Comparative Prospective Analysis

Area of Science:

• Otolaryngology
• Surgical Innovation
• Audiology

Background:

• Adhesive otitis media and pars tensa retractions can lead to hearing loss.
• Traditional microscopic tympanoplasty has been the standard surgical approach.
• Endoscopic techniques offer potential advantages in visualization and access.

Purpose of the Study:

• To compare the outcomes and hearing improvement between endoscopic and microscopic cartilage tympanoplasty.
• To evaluate graft success and postoperative complications in both surgical groups.
• To determine the efficacy of each technique in addressing pars tensa retractions.

Main Methods:

• A prospective study involving 51 patients with adhesive otitis media and hearing loss.
• Patients underwent either endoscopic or microscopic cartilage tympanoplasty.
• Pure-tone audiometry, air-bone gap (ABG) measurements, and graft intake were assessed postoperatively.

Main Results:

• Both endoscopic and microscopic tympanoplasty resulted in significant hearing gain (p<0.05).
• The endoscopic group demonstrated a significantly smaller postoperative air-bone gap (ABG) compared to the microscopic group.
• Endoscopic tympanoplasty showed significant improvements in air conduction thresholds at 0.5, 1, and 2 kHz, with no significant difference at 4 kHz.

Conclusions:

• Both endoscopic and microscopic tympanoplasty yield comparable outcomes for adhesive otitis media and pars tensa retractions.
• Endoscopic tympanoplasty provides enhanced visualization, leading to superior hearing outcomes.
• The endoscopic approach is less invasive and improves access to retraction limits, enhancing surgical efficacy.