Endoscopic Versus Microscopic Tympanoplasty: A Single-Blinded Randomized Comparative Trial.

Area of Science:

• Otolaryngology
• Surgical Innovation
• Evidence-Based Medicine

Background:

• Tympanoplasty is a common surgical procedure to repair tympanic membrane perforations.
• Both endoscopic and microscopic techniques are utilized, but direct comparative evidence on outcomes is limited.

Purpose of the Study:

• To prospectively compare audiometric and patient-reported outcomes between endoscopic and microscopic tympanoplasty.
• To evaluate the efficacy and patient experience of transcanal tympanoplasty using two distinct surgical visualization methods.

Main Methods:

• A single-blinded, prospective randomized comparative trial was conducted.
• Adults with dry tympanic membrane perforations underwent either endoscopic or microscopic tympanoplasty.
• Audiometric measures (air-bone gap, SRT, WRS) and patient-reported outcome measures (PROMs) were assessed.

Main Results:

• No statistically significant differences were observed in audiometric outcomes between the endoscopic and microscopic tympanoplasty groups.
• Patient-reported outcomes, including pain and functional recovery, also showed no significant variations between the two surgical approaches.
• High participant dropout rates beyond 3 weeks limited the analysis of long-term PROMs.

Conclusions:

• Transcanal endoscopic and microscopic tympanoplasty techniques yield comparable postoperative audiometric results.
• Patient-reported outcomes do not significantly differ between endoscopic and microscopic approaches for tympanoplasty.
• Both methods are viable options for treating dry tympanic membrane perforations without significant differences in patient recovery or hearing outcomes.