Abstract
BackgroundThis study compares endoscopic and microscopic tympanoplasty for the treatment of chronic otitis media (COM) without cholesteatoma.MethodsThis retrospective study included 153 ears (139 patients) treated surgically (endoscopic or microscopic tympanoplasty) for COM in the absence of cholesteatoma at our hospital between January 2008 and October 2015. The adoption of transcanal endoscopic ear surgery (TEES) or microscopic ear surgery (MES) was divided temporally (before and since 2014). Comparisons between these groups focused on the following: (I) surgical outcomes, including successful tympanic membrane healing and post-operative complications; (II) restoration of hearing; and (III) consumption of medical resources, including the duration of surgery and anesthesia. All patients had a follow-up period of at least 3 months after surgery.ResultsNo statistically significant differences were observed between the two groups regarding surgical outcome or hearing restoration. TEES resulted in the successful healing of 96.2% of ear drums, whereas MES led to successful healing in 92% (p = 0.2826) of cases. The average hearing gains following surgery were 10.27 ± 6.4 and 12.43 ± 7.46 dB in TEES and MES, respectively. The consumption of medical resources in the TEES group was lower than that of the MES group (TEES versus MES) regarding the average operating time (87.8 ± 19.01 min (mins) versus 110.2 ± 17.0 (mins) (p < 0.0001)) and the mean duration of anesthesia ((for general anesthesia patients) (122.1 ± 21.25 mins versus 145.8 ± 16.88 mins) (p ≤ 0.0001)).ConclusionsThe results indicate that TEES can achieve surgical outcomes and hearing restoration comparable to those of MES. In addition, TEES appears to be associated with shorter surgical and anesthesia time, which makes it an ideal alternative for the management of COM without cholesteatoma.Trial registrationThis study was approved by the Institutional Review Board of the Cathay General Hospital. (CGHIRB No: CGH-P105012).
Highlights
This study compares endoscopic and microscopic tympanoplasty for the treatment of chronic otitis media (COM) without cholesteatoma
As of January 2014, Transcanal endoscopic ear surgery (TEES) was adopted as the primary procedure, and microscopic ear surgery (MES) was used as a salvage technique for patients who were not suitable for TEES
Comparison of surgical outcomes Surgical procedures were adopted in accordance with the severity and extent of the pathology
Summary
This study compares endoscopic and microscopic tympanoplasty for the treatment of chronic otitis media (COM) without cholesteatoma. Conventional microscopic ear surgery (MES) using a post-auricular approach remains the most common tympanoplasty technique. The evolution of endoscopes and other instruments has made EES far more powerful, in the management of ear disease [2]. The feasibility of using EES to manage diseases of the ear has been widely discussed. Most prior studies have focused on the outcomes of EES in the management of cholesteatomas. This paper reports our experience using tympanoplasties to treat COM without cholesteatoma and compares the surgical outcomes, hearing restoration rates, and medical resource consumption of MES and TEES
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