COMPARATIVE STUDY BETWEEN ENDOSCOPIC TRANSCANAL MYRINGOPLASTY VERSUS MICROSCOPIC MYRINGOPLASTY IN MIDDLE AGE GROUP (20-40 YEARS)

Abstract

Background: Myringoplasty (tympanoplasty type I) is usually the treatment of choice for tympanic perforations, whether or not associated with non-suppurative chronic otitis media. Objective: To determine the advantages and disadvantages of endoscopic as compared to microscopic myringoplasty surgery and to compare the results of both groups. Patients and methods: This study was carried out at the Otorhinolaryngology Department, Al-Azhar University Hospitals. The study included 40 patients. The age of all patients was between 20 - 40 years old with a diagnosis of chronic suppurative otitis media of tubo-tympanic type, divided into two equal groups. Results: The difference in age, gender, side of diseased ear and size of perforation between the two groups was not significant. In group (A) the circumference of the perforation was clearly visualized in all patients, while in group (B) the circumference of the perforation could not be visualized in 35% of patients. 25% required external auditory canal curettage and 10% required endoscope assisted microscopic myringoplasty to evaluate the ossicular chain. The difference between the 2 groups was significant. The graft was obtained from the tragal cartilage. In endoscopic group, the graft was uptaken in 85% of patients, while in microscopic group the graft was uptaken in 80% of patients with no statistical significant difference between the two groups. Conclusion: Comparison of microscopic and endoscopic views revealed superior visualization of the endoscopic approach as opposed to microscopic myringoplasty as endoscopic myringoplasty can be performed, regardless of the perforation size and the narrowness and/or protrusion of external ear canal. So, external auditory canal curettage and canalplasty can be avoided in endoscopic technique.