Endoscopic versus Microscopic Tympanoplasty in Patients with Chronic Otitis Media: A Prospective Comparative Study

Original Article

Abstract

Background: Chronic otitis media (COM) is a persistent inflammation of the middle ear that commonly leads to hearing loss and often requires surgical intervention. Tympanoplasty can be performed using either endoscopic or microscopic techniques, both of which may differ in terms of graft success, hearing outcomes, and postoperative recovery.

Objective: To compare surgical outcomes between endoscopic and microscopic tympanoplasty in patients with COM, focusing on graft success rate, hearing improvement, and postoperative recovery.

Methods: This prospective comparative study was conducted in the Department of ENT, Khyber Teaching Hospital, Peshawar, from 12 January 2023 to 12 January 2024. A total of 100 patients with chronic otitis media were enrolled using consecutive non-probability sampling and allocated equally to endoscopic or microscopic tympanoplasty. Outcomes included graft uptake, hearing improvement, operative time, postoperative complications, and recovery. Statistical analysis was performed using the chi-square test and the independent-samples t-test, with p < 0.05 considered statistically significant.

Results: The mean age of the participants was 42.3 ± 10.4 years. The endoscopic group demonstrated a graft success rate of 47/50 (94%), compared with 45/50 (90%) in the microscopic group (p = 0.03). Mean hearing improvement was significantly greater in the endoscopic group (12.5 dB) than in the microscopic group (10.2 dB) (p = 0.034). Patients undergoing endoscopic tympanoplasty also experienced faster recovery and fewer postoperative complications.

Conclusion: Both endoscopic and microscopic tympanoplasty are effective in managing COM. However, the endoscopic approach offers superior hearing outcomes, higher graft success, and faster recovery, making it a favorable option when appropriate