Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 9, pp 3343–3349 | Cite as

Endoscopic versus microscopic type 1 tympanoplasty in the same patients: a prospective randomized controlled trial

  • Isa Kaya
  • Baha SezginEmail author
  • Demet Sergin
  • Arin Ozturk
  • Sevinc Eraslan
  • Sercan Gode
  • Cem Bilgen
  • Tayfun Kirazli
Otology

Abstract

The aim of this study was to compare the audiologic outcomes of the patients who underwent endoscopy on one ear and microscopic tympanoplasty on the other, and to investigate the operative time, graft success, postoperative pain and health status. This prospective randomized controlled study was carried out in Ege University ENT Department between February 2015 and September 2016. The patients who had bilateral chronic otitis media, normal middle ear mucosa and a hearing loss difference of 10 dB or less between the two ears randomly underwent microscopic tympanoplasty in one ear and endoscopic tympanoplasty in the contralateral ear, with 6-month intervals. 13 patients were included in the study with a mean age of 36.17 ± 3.61 years (range 17–53 years, 7 female, 6 male). The improvement in air–bone gap for groups 1 (endoscopic) and 2 (microscopic) was 9.48 ± 5.23 and 9.89 ± 2.79 dB, respectively. The duration of the surgery in group 1 was significantly lower than that in group 2 (p < 0.01). VAS scores were 2.15 ± 0.37 and 3.76 ± 1.64 cm for groups 1 and 2, respectively (p = 0.006). The endoscopic approach for type 1 tympanoplasty offers shorter surgery time, better health status and lower postoperative pain than microscopic surgery. In addition, endoscopic surgery offers comparable improvement in air–bone gap and similar graft success. The endoscopic approach has comparable audiological and morphological graft outcomes with the microscopic one. The endoscopic approach yielded better health and pain status for the same patients.

Level of evidence This is an individual randomized controlled trial. The level of evidence is 1b.

Keywords

Endoscopic tympanoplasty Microscopic tympanoplasty Type 1 tympanoplasty Operative time 

Notes

Compliance with ethical standards

Ethics committee approval

The ethics committee approval was received for this study from the ethics committee of Ege University.

Informed consent

Written informed consent was obtained from patients who participated in this study.

Conflict of interest

No conflict of interest was declared by the authors.

Financial disclosure

The authors declared that this study received no financial support.

References

  1. 1.
    Morris PS, Leach AJ (2009) Acute and chronic otitis media. Pediatr Clin N Am 56:1383–1399CrossRefGoogle Scholar
  2. 2.
    Sheehy JL, Anderson RG (1980) Myringoplasty. A review of 472 cases. Ann Otol Rhinol Laryngol 89:331–334CrossRefPubMedGoogle Scholar
  3. 3.
    Banzer M (1640) Disputatio de Auditione Laesa. Johannis Rohrerei, Wittenbergae, p 1651Google Scholar
  4. 4.
    Blake CJ (1887) Transactions of the first congress of the international otological society. D. Appleton & Company, New YorkGoogle Scholar
  5. 5.
    Berthold E (1878) Uebermyringoplastik. Wier Med Bull 1:627Google Scholar
  6. 6.
    Sooy FA (1956) A method of repairing a large marginal tympanic perforation. Ann Otol Rhinol Laryngol 65(4):911–914CrossRefPubMedGoogle Scholar
  7. 7.
    Shea JJ Jr (1960) Vein graft closure of eardrum perforations. J Laryngol Otol 74:358–362CrossRefPubMedGoogle Scholar
  8. 8.
    House WF, Sheehy JL (1961) Myringoplasty. Use of ear canal skin compared with other techniques. Arch Otolaryngol 73:407–415CrossRefPubMedGoogle Scholar
  9. 9.
    Kartush JM, Michaelides EM, Becvarovski Z, LaRouere MJ (2002) Over-under tympanoplasty. Laryngoscope 112(5):802–807CrossRefPubMedGoogle Scholar
  10. 10.
    Tarabichi M (1999) Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol 108:39–46CrossRefPubMedGoogle Scholar
  11. 11.
    Raj A, Meher R (2001) Endoscopic transcanal myringoplasty—a study. Indian J Otolaryngol Head Neck Surg 53:47–49CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Huang TY, Ho KY, Wang LF, Chien CY, Wang HM (2016) A comparative study of endoscopic and microscopic approach type 1 tympanoplasty for simple chronic otitis media. J Int Adv Otol 12(1):28–31CrossRefPubMedGoogle Scholar
  13. 13.
    Choi N, Noh Y, Park W, Lee JJ, Yook S, Choi JE, Chung WH, Cho YS, Hong SH, Moon IJ (2017) Comparison of endoscopic tympanoplasty to microscopic tympanoplasty. Clin Exp Otorhinolaryngol 10(1):44–49CrossRefPubMedGoogle Scholar
  14. 14.
    Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF (2016) Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: a systematic review and meta-analysis. Laryngoscope. doi: 10.1002/lary.26379 Google Scholar
  15. 15.
    Halim A, Borgstein J (2009) Pediatric myringoplasty: postaural versus transmeatal approach. Int J Pediatr Otorhinolaryngol 73:1580–1583CrossRefPubMedGoogle Scholar
  16. 16.
    Panetti G, Cavaliere M, Panetti M, Marino A, Iemma M (2017) Endoscopic tympanoplasty in the treatment of chronic otitis media: our experience. Acta Otolaryngol 137(3):225–228CrossRefPubMedGoogle Scholar
  17. 17.
    Robinson K, Gatehouse S, Browning GG (1996) Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 105(6):415–422CrossRefPubMedGoogle Scholar
  18. 18.
    McCormack HM, Horne DJ, Sheather S (1988) Clinical applications of visual analogue scales: a critical review. Psychol Med 18:1007–1019CrossRefPubMedGoogle Scholar
  19. 19.
    Bottrill I, Perrault DF Jr, Poe D (1996) In vitro and in vivo determination of the thermal effect of middle ear endoscopy. Laryngoscope 106(2 Pt 1):213–216CrossRefPubMedGoogle Scholar
  20. 20.
    Badr-El-Dine M, James AL, Panetti G, Marchioni D, Presutti L, Nogueira JF (2013) Instrumentation and technologies in endoscopic ear surgery. Otolaryngol Clin N Am 46(2):211–225CrossRefGoogle Scholar
  21. 21.
    Lade H, Choudhary SR, Vashishth A (2014) Endoscopic vs microscopic myringoplasty: a different perspective. Eur Arch Otorhinolaryngol 271:1897–1902CrossRefPubMedGoogle Scholar
  22. 22.
    Karhuketo TS, Ilomaki JH, Puhakka HJ (2001) Tympanoscope-assisted myringoplasty. ORL J Otorhinolaryngol Relat Spec 63:353–357CrossRefPubMedGoogle Scholar
  23. 23.
    Ayache S (2013) Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol 270:853–860CrossRefPubMedGoogle Scholar
  24. 24.
    Kirazli T, Bilgen C, Midilli R, Ogüt F (2005) Hearing results after primary cartilage tympanoplasty with island technique. Otolaryngol Head Neck Surg 132(6):933–937CrossRefPubMedGoogle Scholar
  25. 25.
    Dündar R, Kulduk E, Soy FK, Aslan M, Hanci D, Muluk NB, Cingi C (2014) Endoscopic versus microscopic approach to type 1 tympanoplasty in children. Int J Pediatr Otorhinolaryngol 78(7):1084–1089CrossRefPubMedGoogle Scholar
  26. 26.
    Ghaffar S, Ikram M, Zia S, Raza A (2006) Incorporating the endoscope into middle ear surgery. Ear Nose Throat J 85:593–596PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Otorhinolaryngology DepartmentEge University School of MedicineIzmirTurkey
  2. 2.Anesthesiology and Reanimation DepartmentEge University School of MedicineIzmirTurkey

Personalised recommendations