Transcanal Endoscopic Tympanoplasty: Our Experience at a Tertiary Care Centre.

Abstract

Transcanal Myringoplasty can be performed with both microscope and endoscopes. Advancement in endoscopes has started the new era of minimal invasive surgery in otology practice. Endoscopic approach offers improved visualization with wider field of view, easy access to the hidden recesses of the middle ear, avoidance of a postauricular incision and less bony drilling. To report our experience with transcanal endoscopic tympanoplasty for tubotympanic type of COM and to evaluate its outcome in terms of morphological and functional success. Prospective study, conducted during September 2017 to August 2019, including 60 patients of tubotympanic type of COM. All patients underwent transcanal endoscopic type 1 tympanoplasty. Postoperative results i.e. graft uptake (morphological success) and hearing improvement (functional success) were evaluated at 6months. The graft take up rate was 93.33%. Preoperatively mean AB gap was 23.15 ± 7.23dB which was reduced to 11.68 ± 4.65dB at 6month postoperative follow up. The mean gain in AC threshold and AB gap was 15.43 ± 4.37dB and 11.46 ± 1.13dB respectively. Improvement in both AC threshold and AB gap was statistically significant (p < 0.0001). No major surgical or thermal injury related complications were observed. Although both microscopic and endoscopic techniques have their advantages and disadvantages, endoscopic technique can effectively replace traditional microscopic techniques in management of COM with satisfactory outcomes. We infer that EES offers less operative time, less postoperative pain, least complications and less hospital stay thus helping to reduce the physical and psychological burden placed on patients.