Endoscopes as an alternative to microscopes for tympanoplasty: a comparative study

Background: The objective of the study was to evaluate and compare the results of endoscope assisted tympanoplasty with microscope assisted tympanoplasty. Methods: A prospective comparative study was conducted from January 2020 – September 2021 and included 60 patients of either sex in age group of 18-50 years having unilateral or bilateral inactive (mucosal) chronic otitis media with central perforation. Patients were randomly divided into 2 groups comprising of 30 patients each. Group-A (n=30) patients underwent endoscope assisted tympanoplasty while group-B (n=30) patients underwent microscope assisted tympanoplasty. Results: The overall graft take up rate in group-A and group-B was 93.33% and 96.67% respectively. In group-A, graft take-up was 90.90% in grade-IV perforations and 88.89% in grade-V perforations and graft take-up was 100% in grade-II and grade-III perforation. While in group-B, graft take-up was 91.67% for grade-III perforations, and 100% uptake was seen in grade-I, grade-IV and grade-V perforation. In group-A, pre-operative average air bone (AB) gap was 30.95 dB and post operatively it was 14.44 dB with an average hearing gain of 16.55dB while in group-B, the average pre-operative AB gap was 32.81dB and post-operative AB gap was 13.71dB with an average hearing gain of 19.11dB. Mean average time taken in group-A was 79.83±8.78 minutes, while in group-B it was 101.13±11.07 minutes. The average pain assessment score was 4.9 in group-A as compared to a score of 5.4 in group-B. Conclusions: The results of endoscope assisted and microscope assisted tympanoplasty are comparable. The operating microscope and endoscope should be employed as per the patient’s requirement and surgeon’s expertise.