Comparative Study of the Outcomes of Tympanoplasty by the Conventional Microscopic and Endoscopic Techniques
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 9
Abstract
Introduction: Chronic otitis media, a highly prevalent middle ear disease, poses problems of recurrent ear discharge and hearing impairment. Tympanoplasty is the surgical remedy, and its outcome varies with the surgical technique used. The introduction of the operating microscope improved the accuracy of the technique; however, difficulty in visualization of certain areas of the middle ear including the anterior and posterior epitympanic spaces and sinus tympani made it necessary for frequent adjustments in either the microscope or the patient’s head. This made endoscopic tympanoplasty a more favorable technique for better visualization of hidden areas in the middle ear cavity with effective removal of disease. Purpose: This study, therefore, aimed to correlate the outcome of tympanoplasty by microscopic and endoscopic methods comparing the advantages and disadvantages of both. Methods: This is a prospective cohort study done on patients undergoing tympanoplasty type I at the Department of ENT, Government Medical College, Kozhikode, from January 2016 to January 2017. They were divided into two groups: Group A tympanoplasty type I by conventional microscopic techniqueand Group B by endoscopic technique respectively. Intraoperatively, the duration of surgery and postoperatively, the graft uptake and hearing improvement were assessed. Results: In our study with 40 patients, 20 each undergoing tympanoplasty by microscopic and endoscopic techniques, it was found that the graft uptake was 95% in both the groups. There was a significant difference between the two groups in duration of surgery, with a shorter duration in the endoscopic group. There were two cases of wound infection in Group A which was not statistically significant. There was significant improvement in hearing in both groups, but the difference was not statistically significant. Conclusion: The endoscopic technique is an effective alternative to the conventional microscopic method but requires more training. The advantages with endoscope include that it is less invasive, less morbid, provides better visualization and better cosmetic results with the definite advantage of shorter duration of surgery in well trained hands. The disadvantages include the learning curve, loss of one hand in holding the endoscope and difficulty in cases of bleeding.
Authors and Affiliations
R T Abdul Salam, Sapna Sreedharan Nambiar, V Anusha
Keywords
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