Endoscopic versus Microscopic Myringoplasty in Anterior Central Tympanic Membrane Perforations

Objective: To compare the surgical and functional outcomes of endoscopic and microscopic myringoplasty (MM) in reconstructing anterior central tympanic membrane (TM) perforations. Patients and Methods: A prospective comparative study was conducted on fifty patients with anterior TM perforation who were randomly and equally distributed among two groups for EM and MM. Both groups were compared regarding the operative details and postoperative outcomes. Results: The graft success rates after 6 months for EM and MM were 88% and 72% respectively ( p=0.157 ). The operative duration was significantly shorter in the EM group ( p<0.001 ). Intra-operative blood loss was significantly less in EM ( p<0.001 ). ABG was significantly improved in both groups ( P<0.001 ) with no significant difference between the two groups ( P=0.081 ). Post-operative pain was significantly less in EM ( p<0.001 ). There was no significant difference between the two groups regarding the complications ( P=0.049 ) with no complications with EM. In both groups, there was no difference between patients with anterior canal wall protrusion (ACWP) and patients without ACWP regarding operative duration ( p=0.123 and 0.372 respectively). There was a significant relationship between ACWP and the graft taking rate after 6 months in both groups ( p=0.015 and p<0.001 respectively). Conclusion: Despite having comparable success rates in reconstructing anterior central TM perforations with both EM and MM, EM offering a shorter duration of surgery, less blood loss, less postoperative pain, and fewer complications, may serve as an acceptable and reasonable alternative to MM. endoscopic ear surgery, microscopic ear surgery, myringoplasty.