Comparative study of minimally invasive endoscopic tympanoplasty with microscopic tympanoplasty

Background: Chronic suppurative otitis media (CSOM) is a disease of a low-socioeconomic group with high prevalence in India. Tympanoplasty is a common procedure done for CSOM. Hopkins endoscopes are now more popular for various ear surgeries due to better optics, portability, and cost-effectiveness. The objective was to compare the surgical outcome of minimally invasive endoscopic tympanoplasty and microscopic tympanoplasty. Materials and Methods: A prospective follow-up comparative study was performed on 60 patients who underwent tympanoplasty from January 2021 to December 2021. The subjects were divided equally and randomly into two groups (endoscopic group and microscopic group). Demographic data, perforation size of the tympanic membrane, pure-tone audiometry results preoperatively, and at the 8th week postoperatively, type of anesthesia used, average surgical time, postoperative morbidity, and graft uptake rate in both the groups were compared. Results: Graft uptake was 93% in the endoscopic group and 96% in the microscopic group. Postoperative morbidity was more in the microscopic group as compared to the endoscopic group. Average surgical time was less in the endoscopic group as compared to the microscopic group. Endoscopic tympanoplasty was done under local anesthesia and is economically more acceptable to the patient as compared to the microscopic group. The mean air–bone gap gain was 16.44 dB in the endoscopic group and 16.07 dB in the microscopic group. Conclusion: With minimally invasive endoscopic procedure, it is possible to get a similar graft uptake rate and hearing gain as compared with conventional microscopic procedure with the advantage of having less postoperative morbidity and lesser consumption of medical resources. Thereby making it a more cost-effective technique and can be easily performed in remote places.