Comparison of endoscopic and microscopic tympanoplasty

Tympanoplasty was conventionally performed using a microscope for decades. However, since the endoscope began to be used in middle ear surgery in the 1970s, endoscopic tympanoplasty has gained increasing attention. The main objective of this study was to compare endoscopic and microscopic tympanoplasty with and without ossiculoplasty, demonstrating the potential advantages, disadvantages, and outcomes of each. This retrospective study included 126 patients with chronic otitis media who received tympanoplasty from 2013 to 2015 in our hospital. The clinical follow-up continued for at least 3 months postoperatively. Otoscopy and audiometry were conducted before and after the procedure. The different variables affecting surgical outcomes were thoroughly documented in each case. A total of 126 patients (131 ears) were included in this retrospective study. Moreover, 74 and 57 ears underwent endoscopic and microscopic tympanoplasty, respectively. The overall endoscopic tympanoplasty graft uptake rate was 97.7% (128/131). The operation time was significantly shorter in the endoscopic group statistically. A paired t test was used to compare pre- and postoperative audiometry results and showed significant differences between the endoscopic and microscopic groups. However, no statistically significant difference was observed in audiometry improvement between the two groups. No major complications were observed in any of the patients. Our study demonstrated that endoscopic tympanoplasty can be feasibly applied in middle ear surgery. The success rate, audiometry improvement, and complication rate are comparable between endoscopic tympanoplasty and conventional microscopic tympanoplasty. Moreover, the endoscopic group had smaller operation wounds and lower medical expenditures.