Arjita Sharda1 , Siddharth Chaudri2 , Mihir Suryavanshi3
BACKGROUND An endoscope offers a new perspective of surgical procedures; it increases the surgeon’s understanding of the disorder and its extension and provides a wide field of view of the middle ear compared to a microscope. In this study, we are comparing microscopic and endoscopic techniques for type I tympanoplasty on the basis of subjective and objective parameters which includes graft uptake, hearing improvement, postoperative pain and paraesthesia of the pinna and postaural area evaluated on visual analogue scale, cosmesis in terms of scar, scar related complications etc. METHODS We have included 66 patients in two groups according to the inclusion and exclusion criteria; 33 underwent endoscopic tympanoplasty; 33 underwent microscopic tympanoplasty; at the end of 1st , 6 th and 12th week, we have compared the two on the basis of subjective and objective parameters i.e. improvement in air-bone gap at end of 12 weeks, graft uptake, postoperative pain and paraesthesia of the pinna and postaural area, evaluated on visual analogue scale, and cosmesis in terms of scar, scar related complications. RESULTS Statistically significant differences were found with regard to postoperative pain, paraesthesia and anaesthesia of the pinna and postaural region, cosmesis in terms of scar which favoured endoscopic tympanoplasty. Statistically nonsignificant differences were found with regard to improvement in hearing, and scar related complication. Objective parameters when studied and compared, results were found to be statistically insignificant in terms of improvement in hearing threshold as demonstrated by pure tone audiometry, and healed perforation as seen on otoendoscopy. CONCLUSIONS While comparing the success rates of endoscopic tympanoplasty and microscopic tympanoplasty, both the surgical techniques showed equal success rates in terms of graft uptake, subjective hearing improvement as well as air bone gap closure on pure tone audiometry. However, in terms of cosmesis and postoperative pain endoscopic tympanoplasty does have better results which are statistically significant. Postoperative paraesthesia and anaesthesia of pinna and postaural area were significant in microscopic tympanoplasty.
