Comparative Outcomes of Endoscopic and Microscopic Tympanoplasty in Patients with Tympanic Membrane Perforation at HRH Princess Maha Chakri Sirindhorn Medical Center

Charinchart Tiamchat; Nattarat Trinusonth

Authors

Charinchart Tiamchat Medical Office, Royal Thai Armed Forces Headquarters
Nattarat Trinusonth Department of Otolaryngology, Faculty of Medicine, Srinakharinwirot University

Keywords:

microscopic tympanoplasy, endoscopic tympanoplasty, graft take rate, complication, satisfaction

Abstract

Chronic otitis media with perforated eardrum is a common disease. Treatment involves tympanoplasty to heal the perforated eardrum. Traditionally, microscopic tympanoplasty (postauricular approach) has been used as the conventional method, but since the 1990s, endoscopic tympanoplasty (transcanal approach) have been used in tympanic membrane surgery. However, endoscopic-assisted surgery compels the doctor to use only one hand to perform the procedure since the other hand is used to hold the camera. Also, the operation area is small, and if bleeding occurs, it may easily obscure the surgical site. A total of 20 patients with tympanic membrane perforation were enrolled in this study and divided into two groups: endoscopic tympanoplasty using tragal perichondrium graft (n=10) and microscopic tympanoplasty using temporalis fascia graft (n=10). Graft success rates and patient satisfaction were evaluated. Clinical outcomes and complications were followed for at least 6 months postoperatively. Independent t-test, Mann–Whitney U test were used to analyze the outcomes and repeated measures analysis of variance was used to analyze pain score. The mean operation time and length of hospital stay were significantly longer in the microscopic tympanoplasty group (145 minutes, 70 hours) than the endoscopic tympanoplasty groups (90 minutes, 47 hours) (p<0.001). Graft success rates, clinical outcomes, and satisfaction scores were not significantly different between the two groups. No major complications were observed in either group.

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