Endoscopic Versus Microscopic Myringoplasty Through Endaural Approach

Abstract

Introduction: Different approaches were used for myringoplasty mainly the post-auricular, the endaural and trans-canal using either the endoscopic or the microscopic. This study aims to compare endoscopic myringoplasty with microscopic myringoplasty through end aural approach using temporalis fascia graft regarding operative technique, success rate and postoperative hearing improvement. Patients and Methods: The work was performed at the ENT Department, Al-azhar University hospitals. The work involved 40 cases diagnosed to have chronic suppurative otitis media of tubotympanic type submitted to myringoplasty operation. They were classified into Class A: endoscopic myringoplasty and Class B: microscopic myringoplasty through endaural approach. Results: The graft was taken after 3 months in 18 cases (90%) in class A and in 17 cases (85%) in class B. The mean of Preoperative airbone gab (ABG) was 22.85±10.34db in group A and the mean postoperative ABG was 5.5 ±2.15 db while the mean Preoperative ABG was 25.75±5.90 db in class B and the mean postoperative ABG was 7 ±3.25 db with statistically significant difference between Preoperative and postoperative ABG ( p value <0.05), also in class A, the perforation circumference was definitely visible in whole cases (100%) without the necessity for external auditory canal drilling or curettage, whereas in class B, it was only partially visible in 7 cases (35%). Conclusion: Regardless of the perforation's width, the external auditory canal's narrowness, or its protrusion, an endoscopic myringoplasty can be done. The best hope for ear surgery in the future is the endoscope.