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Updated: Sep 14, 2025

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

Aparna Govindan1, Mia Saade2, Jennifer Ren3

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Miami/Jackson Health System, Miami, Florida.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|July 21, 2025
PubMed
Summary

Endoscopic and microscopic tympanoplasty show similar results for hearing and patient-reported outcomes. This study compared these surgical techniques for eardrum repair, finding no significant differences in recovery or hearing improvement.

Keywords:
EndoscopicOperative microscopyPatient-reported outcomesTympanoplasty

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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.