Traditional microscopic tympanoplasty has long been a standard intervention, but a clinical gap exists in comprehensively comparing its quality-of-life outcomes with newer transcanal endoscopic approaches; to address this, Rubeena Arora and colleagues aimed to compare the success rates and patient-reported parameters of endoscopic versus microscopic tympanoplasty.
Therefore, the retrospective study compared the 12-month outcomes of endoscopic versus conventional microscopic Type 1 tympanoplasty in 195 patients with inactive chronic otitis media. The researchers evaluated graft success, hearing improvement, operative time, and postoperative pain for both surgical approaches.
Key clinical findings of the study include:
Graft Success: The study found successful graft uptake in 90.8% of the endoscopic group compared to 88.7% in the microscopic group, representing a non-significant difference (p=0.62).
Hearing Outcomes: The study reported an average air-bone gap closure of 17.4 ± 3.88 decibels (dB) for the endoscopic approach and 16.8 ± 3.46 dB for the microscopic approach, yielding comparable audiological results (p = 0.256).
Postoperative Pain: The study demonstrated significantly lower VAS pain scores for endoscopic patients at 24 hours (0.63 vs. 2.55) and at 7 days (0.21 vs. 1.09) compared to the microscopic cohort (p=0.001).
Operative Time: The study confirmed that the endoscopic method is significantly faster, requiring an average of 34.3 minutes versus 47.9 minutes for the microscopic technique (p=0.001).
The results suggest that while both surgical modalities deliver equivalent graft uptake and audiological restoration, the endoscopic transcanal approach provides distinct advantages in reducing surgical duration and minimizing early postoperative discomfort.
Thus, the study concludes that clinicians may consider prioritizing transcanal endoscopic tympanoplasty to optimize operative efficiency and enhance the early postoperative recovery experience for patients with inactive mucosal COM.
Reference
Arora, R., Chaudhary, M., Singh, J., Barkhane, M., Rawal, D., Goyal, A., & Rawat, V. (2026). A Comparison of Endoscopic and Microscopic Tympanoplasty Type 1 in a Developing Country: How We Do It. Indian Journal of Otolaryngology and Head & Neck Surgery.
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