COMPARISON OF GRAFT UPTAKE AND HEARING RESULTS BETWEEN ENDOSCOPIC AND MICROSCOPIC UNDERLAY MYRINGOPLASTY

Abstract

Objective: To compare the graft uptake rate  postoperative hearing results between endoscopic and microscopic underlay myringoplasty.

Materials and methods: Patients of age 13 years and above with the diagnosis of chronic otitis media – mucosal type with any sized perforation of tympanic membrane were included for myringoplasty. The study was conducted at Ganesh Man Singh Memorial Academy of ENT Head and Neck Studies, Tribhuvan University Teaching Hospital between April 2013 to October 2014. Sixty cases were included for underlay myringoplasty with temporalis fascia graft. Patients were randomly allocated by lottery method with 30 cases in endoscopic group and 30 cases in microscopic group. Graft uptake and hearing results were assessed after 6 weeks and results were compared within and between the groups.

Results: Graft uptake rate in endoscopic group was 83.3% (25/30) and in microscopic group was 86.6%(26/30) with no statistically significant difference in the graft uptake rate (p = 0.718) between the groups. The mean pre and post-operative air bone gap in endoscopic group were 26.96dB ± 7.98dB, 12.58dB ± 5.58dB and that in the microscopic group were 28.80 ± 9.78dB, 10.45dB ± 4.96dB, respectively. The difference obtained within the groups was statistically highly significant (p < 0.001). However, there was no statistically significant difference in hearing results between the two groups (p = 0.457).

Conclusion: The graft uptake results of endoscopic underlay myringoplasty are comparable to those of microscopic underlay myringoplasty. Thus, endoscope can be used as an alternative option for microscope for the repair of tympanic membrane perforations.

Keywords: chronic otitis media, Endoscope, Myringoplasty, Pure tone audiometry, Temporalis Fascia