Endoscopic Versus Microscopic Cartilage Myringoplasty in Chronic Otitis Media

Abstract

Introduction: Operations on the tympanic membrane of the middle ear, myringoplasty, and tympanoplasty are now widely accepted, and attempts are underway all over the world to standardize the surgical techniques. This study aimed to compare postoperative outcomes of endoscopic and microscopic cartilage myringoplasty in patients suffering from chronic otitis media (COM).

Materials and methods: This clinical trial study compared 130 patients with COM who underwent transcanal endoscopic myringoplasty by repairing perforation using auricular concha cartilage under general anesthesia (n=75) and conventional repairing method by postauricular incision and tympanomeatal flap elevation under microscopic surgery (n=55).

Results: According to the results, there was no significant difference between the two groups in terms of hearing gain 1, 6, and 12 months after surgery (P=0.063); however, higher hearing gain scores were observed in the endoscopic group. Moreover, lower recovery time and post-operative pain were reported in patients who underwent the endoscopic approach, compared to those who treated with the conventional repairing method (P<0.001).

Conclusion: Endoscopic myringoplasty technique is a safe and effective way to improve hearing loss as much as the conventional method. However, due to the lower recovery time and post-operative pain, it seems to be the method of choice in myringoplasty surgery.

Keywords: Cartilage; Endoscopic; Myringoplasty; Tympanoplasty.

Fig 1

A. Limited perforation after freshening up the edges. B. After performing a radial incision and extending to the posterosuperior margin. C. Middle ear structures and ossicles are easily visualized by the endoscope

Fig 2

Postoperative hearing gain (dB) 1, 6, and 12 months after surgery