Comparative Analysis of Endoscopic and Microscopic Myringoplasty.

Introduction: Myringoplasty is a surgical procedure aimed at reconstructing the tympanic membrane, restoring acoustic protection to the round window, and improving sound conduction to enhance hearing, and prevent recurrent infections or otorrhea. This procedure can be performed either through microscopy or endoscopy.

Objective: To compare the outcomes of endoscopic myringoplasty and microscopic myringoplasty.

Methods: Data were retrospectively collected from the electronic medical records of patients who underwent myringoplasty either through microscopy or videoendoscopy at Hospital do Servidor Público Estadual de São Paulo (HSPE) between December 2015 and December 2020. We evaluated the therapeutic success rate, defined as tympanic membrane closure, the variation in the pre- and postoperative speech recognition threshold (SRT), and the incidence of immediate and late complications in each group.

Results: We included 118 patients: 64 underwent microscopic myringoplasty (group 1) and 54, videoendoscopic myringoplasty (group 2). The groups were comparable in terms of mean age, sex, and body mass index (BMI). The surgical success rates were similar between the 2 groups: group 1: 70.3%; and group 2: 75.9% ( p  = 0.494). Group 1 presented a significant improvement in the mean postoperative hearing thresholds (30.0 ± 14.9) compared to the mean preoperative levels (41.0 ± 16.3) ( p  < 0.001), while group 2 did not present a statistically significant improvement (from 37.8 ± 14.7 preoperatively to 32.0 ± 20.7 postoperatively; p  = 0.284).

Conclusion: Microscopic and endoscopic myringoplasty yielded similar tympanic membrane closure rates. However, the videoendoscopic procedures resulted in lower SRT reduction, while the microscopic procedures resulted in a higher rate of immediate postoperative complications.

Level of evidence: 3.