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Scaling Up Endoscopic Tympanoplasty: A Dual-Station Workflow in Resource-Limited Settings
Saithip Chaisuwan1, Pornsek Tananuchittikul2,3
1Department of Otolaryngology, Maesot General Hospital, Tak, Thailand.
Objective:
This study evaluated the feasibility, outcomes, and safety of a dual-station (DS) workflow for endoscopic tympanoplasty compared with conventional single-station (SS) surgery in a resource-limited hospital setting.
Study Design:
A retrospective chart review.
Setting:
Maesot General Hospital.
Methods:
Patients aged 18 to 80 years undergoing endoscopic tympanoplasty were included. DS was implemented during outreach missions (March 2024 and March 2025), whereas SS was performed between August 2023 and August 2025. Primary outcomes included graft success rate, operative time, and complications; audiologic outcomes were secondary.
Results:
Among 78 eligible patients, 68 met the final criteria and were included (DS, n = 28; SS, n = 40). The DS workflow achieved 7.75 ± 0.50 cases/room/day. Graft success (DS 82.14% vs SS 82.5%, P = .999) and operative time (DS 105.18 ± 27.23 vs SS 100.12 ± 35.56 minutes, P = .529) were comparable. No wound infections occurred in the DS group versus one in the SS group (P = .831), and no serious complications were observed. Both groups showed significant improvements in air-conduction thresholds and ABG (P < .001) without intergroup differences (P = .910 and P = .510). ABG ≤ 10 dB occurred in 46.43% (DS) vs 52.63% (SS), and 11 to 20 dB in 39.29% vs 39.47% (P = .724).
Conclusion:
The DS workflow for endoscopic tympanoplasty appears feasible and safe for increasing surgical capacity without compromising graft success, audiologic outcomes, or complication rates. This model may provide a practical framework for outreach or ear-camp endoscopic ear surgery in resource-limited settings.
