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

International Journal of Otorhinolaryngology and Head and Neck Surgery Pub Date : 2024-07-26 DOI:10.18203/issn.2454-5929.ijohns20242042

Pratik Kumar, J. Gulia, Nikhil Arora, Bhavesh Kumar, Parmod Jangra

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Abstract

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.

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鼓室成形术中内窥镜与显微镜的对比研究

背景：该研究旨在评估和比较内窥镜辅助鼓室成形术与显微镜辅助鼓室成形术的效果：研究目的是评估和比较内窥镜辅助鼓室成形术与显微镜辅助鼓室成形术的效果：这项前瞻性比较研究于 2020 年 1 月至 2021 年 9 月进行，共纳入 60 名 18-50 岁年龄组的单侧或双侧非活动性（粘膜）慢性中耳炎伴中央穿孔的男女患者。患者被随机分为两组，每组 30 人。A组（30人）患者接受内窥镜辅助鼓室成形术，B组（30人）患者接受显微镜辅助鼓室成形术。结果：A 组和 B 组的移植物总吸收率分别为 93.33% 和 96.67%。在A组中，IV级穿孔的移植物吸收率为90.90%，V级穿孔的移植物吸收率为88.89%，II级和III级穿孔的移植物吸收率为100%。而在 B 组，III 级穿孔的移植物吸收率为 91.67%，I 级、IV 级和 V 级穿孔的移植物吸收率为 100%。在 A 组中，术前平均气骨（AB）间隙为 30.95 分贝，术后为 14.44 分贝，平均听力增益为 16.55 分贝；而在 B 组中，术前平均气骨间隙为 32.81 分贝，术后为 13.71 分贝，平均听力增益为 19.11 分贝。A 组的平均时间为（79.83±8.78）分钟，B 组为（101.13±11.07）分钟。A 组的平均疼痛评估分数为 4.9 分，而 B 组为 5.4 分：结论：内窥镜辅助鼓室成形术和显微镜辅助鼓室成形术的效果相当。手术显微镜和内窥镜的使用应根据患者的要求和外科医生的专业知识而定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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International Journal of Otorhinolaryngology and Head and Neck Surgery

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