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. 2017 Sep;69(3):357-362.
doi: 10.1007/s12070-017-1147-9. Epub 2017 Jun 27.

Endoscopic Myringoplasty Versus Microscopic Myringoplasty in Tubotympanic CSOM: A Comparative Study of 120 Cases

A C Jyothi  1 , B H Shrikrishna  1 , N H Kulkarni  1 , Ajay Kumar  1
Affiliations

Endoscopic Myringoplasty Versus Microscopic Myringoplasty in Tubotympanic CSOM: A Comparative Study of 120 Cases

A C Jyothi et al. Indian J Otolaryngol Head Neck Surg. 2017 Sep.

Abstract

Myringoplasty is one of the commonest operations performed on the middle ear. Our aim was to compare the results of endoscopic permeatal myringoplasty with that of conventional myringoplasty by post aural approach using operating microscope. A total of 120 patients having central perforation of tympanic membrane were randomly divided into two equal groups of 60 patients each. In the first group, endoscope was used and in the second group microscope was used to do myringoplasty. Temporalis fascia was used as a graft material. The patients were kept in follow-up for 1 year. The pre-operative and post-operative audiograms, post-operative pain, graft uptake and time taken for surgery were compared in both the groups. The graft uptake rate was 91.67% in the endoscopic group, whereas it was 93.3% in the microscopic group. Post-operative pain was significantly less in the endoscopic group as compared with microscopic group and not much difference was found in the gain in A-B gap in either group. The mean ABG gain was 16.16 dB (SD = 4.68) in endoscopic group and 19.54 dB (SD = 3.45) in microscopic group. On applying the Mann-Whitney U test, this finding was statistically significant (p value = 0.0001). In our study success rate was equal between endoscopic and microscopic technique. In terms of morbidity and postoperative recovery endoscope produced better results. Endoscopic tympanoplasty can be a good alternative of microscopic tympanoplasty.

Keywords: CSOM; Conventional myringoplasty; Endoscopic myringoplasty; Oto-endoscopy; Post aural approach.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
In endoscopic myringoplasty, malleus was skeletonised and tympano meatal flap was positioned antero-superiorly before placing the graft
Fig. 2
Fig. 2
In endoscopic myringoplasty, temporalis fascia was placed below the handle of malleus
Fig. 3
Fig. 3
1 year follow up picture of a case of endoscopic myringoplasty shows successful graft uptake
Fig. 4
Fig. 4
Chart showing the air-bone gap levels pre- and post-operatively in both endoscopic and microscopic techniques
See this image and copyright information in PMC

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