Comparing the Efficacy of Microscopic Tympanoplasty (MT) and Endoscopic Tympanoplasty (ET) For Tympanic Membrane and Middle Ear Surgery
Microscopic Versus Endoscopic Tympanoplasty
DOI:
https://doi.org/10.54393/pjhs.v6i8.3199Keywords:
Endoscopic Tympanoplasty, Microscopic Tympanoplasty, Middle Ear Surgery, Audiological OutcomesAbstract
Endoscopic tympanoplasty and microscopic tympanoplasty is performed to restore hearing. But ET superior to MT as it less invasive. Objective: To evaluate the comparative efficacy of endoscopic tympanoplasty vs microscopic tympanoplasty for middle ear and tympanic membrane surgery. Methods: A prospective, quasi-experimental study was conducted in the ENT and Surgical Department of Bakhtawar Amin Memorial Trust Hospital, Multan from 15th October 2024 to 15th May 2025. A total of 100 adult patients undergoing type 1 endoscopic tympanoplasty or microscopic tympanoplasty were selected for the study by convenience sampling. Preoperative and postoperative air conduction, air bone gap and bone conduction were measured by pure tone. Picture archiving and communication system was used to perform preoperative speech audiometry to measure the perforation size. Results: The average surgery duration in endoscopic group was 79.23 ± 11.97 minutes and in microscopic group was 93.05 ± 19.81, which was significantly longer than the former (p<0.001). The length of hospital stay was also significantly short in endoscopic group (4.44 ± 1.11 min) due to less postoperative pain and minimally invasive procedure than microscopic group (8.09 ± 1.27 min) (p<0.001). On follow up, 5 (10%) patients in endoscopic group and 6 (12%) patients had a re-perforation (p=1.0). There was no significant difference between incidence of otorrhea (6% vs 12%, p=0.36) and pain (4% vs 2%, p>0.05). Conclusions: The audiological outcomes between type 1 endoscopic tympanoplasty and microscopic tympanoplasty were similar. However, surgical duration and length of hospital stay was better in endoscopic group.
References
Stefan I, Stefanescu CD, Vlad AM, Zainea V, Hainarosie R. Postoperative outcomes of endoscopic versus microscopic myringoplasty in patients with chronic otitis media-a systematic review. Medicina. 2023 Jun; 59(6): 1074. doi: 10.3390/medicina59061074. DOI: https://doi.org/10.3390/medicina59061074
Verma PK, Singh C, Kumar S, Rana AK. Comparative study of minimally invasive endoscopic tympanoplasty with microscopic tympanoplasty. Indian Journal of Otology. 2023 Jan; 29(1): 27-32. doi: 10.4103/indianjotol.indianjotol_145_22. DOI: https://doi.org/10.4103/indianjotol.indianjotol_145_22
Wang TC, Shih TC, Chen CK, Hsieh VC, Lin DJ, Tien HC et al. Endoscopic Versus Microscopic Type I Tympanoplasty: An Updated Systematic Review and Meta‐analysis. Otolaryngology-Head and Neck Surgery. 2024 Mar; 170(3): 675-93. doi: 10.1002/ohn.597. DOI: https://doi.org/10.1002/ohn.597
Bianchini AJ, Berlitz VG, Mocelin AG, Ribeiro JF, Keruk JG, Hamerschmidt R. Endoscopic or microscopic tympanoplasty advantages and disadvantages: a theory domain systematic review. International Archives of Otorhinolaryngology. 2023 Jul; 27(03): e528-35. doi: 10.1055/s-0042-1748808. DOI: https://doi.org/10.1055/s-0042-1748808
Iynen I and Dündar R. Chorda Tympani nerve injury during tympanoplasty. Comparison of endoscopic and microscopic methods. Annali Italiani di Chirurgia. 2021 Mar; 92(2): 119-22.
Monteiro EM, Beckmann S, Pedrosa MM, Siggemann T, Morato SM, Anschuetz L. Learning curve for endoscopic tympanoplasty type I: comparison of endoscopic-native and microscopically-trained surgeons. European Archives of Oto-Rhino-Laryngology. 2021 Jul; 278(7): 2247-52. doi: 10.1007/s00405-020-06293-0. DOI: https://doi.org/10.1007/s00405-020-06293-0
Ojha T, Yogi V, Kansara A, Sharma K. Endoscopic Tympanoplasty: Is it Better than Microscopic Tympanoplasty? Our Experience. Journal of Mahatma Gandhi University of Medical Sciences and Technology. 2021 Jan; 4(2): 53-6. doi: 10.5005/jp-journals-10057-0104. DOI: https://doi.org/10.5005/jp-journals-10057-0104
Saini S, Khan SR Beig S, Singhal V, BEIG S. Audiological Outcome of Tympanoplasty With Mastoidectomy in M,iddle-Aged and Younger Patients With Chronic Otitis Media. Cureus. 2024 Dec; 16(12). doi: 10.7759/cureus.75121. DOI: https://doi.org/10.7759/cureus.75121
Lee HS, Yoon CY, Pak D, Lee JH, Seo YJ, Kong TH. Learning curve comparable study of microscopic and endoscopic type 1 tympanoplasty. European Archives of Oto-Rhino-Laryngology. 2023 Jun; 280(6): 2741-8. doi: 10.1007/s00405-022-07777-x. DOI: https://doi.org/10.1007/s00405-022-07777-x
Uştu EK, Tahir E, Kemal Ö, Aktaş M. Comparison of Endoscopic and Microscopic Type 1 Tympanoplasty on Surgical Outcomes and Quality of Life. The Turkish Journal of Ear Nose and Throat. 2023 Dec; 33(4): 105-10. doi: 10.26650/Tr-ENT.2023.1348679. DOI: https://doi.org/10.26650/Tr-ENT.2023.1348679
Gkrinia E, Ntziovara AM, Brotis AG, Tzimkas‐Dakis K, Saratziotis A, Korais C et al. Endoscopic versus microscopic tympanoplasty: a systematic review and metanalysis. The Laryngoscope. 2024 Aug; 134(8): 3466-76. doi: 10.1002/lary.31365. DOI: https://doi.org/10.1002/lary.31365
Crotty TJ, Cleere EF, Keogh IJ. Endoscopic versus microscopic type‐1 tympanoplasty: A meta‐analysis of randomized trials. The Laryngoscope. 2023 Jul; 133(7): 1550-7. doi: 10.1002/lary.30479. DOI: https://doi.org/10.1002/lary.30479
Kim DJ, Lee HM, Choi SW, Oh SJ, Kong SK, Lee IW. Comparative study of endoscopic and microscopic tympanoplasty performed by a single experienced surgeon. American Journal of Otolaryngology. 2021 Jan; 42(1): 102788. doi: 10.1016/j.amjoto.2020.102788. DOI: https://doi.org/10.1016/j.amjoto.2020.102788
Yang Q, Wang B, Zhang J, Liu H, Xu M, Zhang W. Comparison of endoscopic and microscopic tympanoplasty in patients with chronic otitis media. European Archives of Oto-Rhino-Laryngology. 2022 Oct; 279(10): 4801-7. doi: 10.1007/s00405-022-07273-2. DOI: https://doi.org/10.1007/s00405-022-07273-2
Elnahal KB, Hassan MA, Maarouf AM. Comparison of endoscope-assisted and microscope-assisted type I tympanoplasty; a systematic review and meta-analysis. European Archives of Oto-Rhino-Laryngology. 2024 May; 281(5): 2243-52. doi: 10.1007/s00405-023-08305-1. DOI: https://doi.org/10.1007/s00405-023-08305-1
Zakir I, Ahmad AN, Pasha HA, Aqil S, Akhtar S. Comparison of endoscopic versus microscopic tympanoplasty. Iranian Journal of Otorhinolaryngology. 2022 May; 34(122): 139-143. doi: 10.22038/IJORL.2022.61234.3104.
Ulkumen B and Yuceturk AV. Endoscopic versus microscopic tympanoplasty: A prospective randomized comparison of outcomes: Endoscopic versus microscopic tympanoplasty. Journal of Surgery and Medicine. 2025 Feb; 9(2): 18-22. doi: 10.28982/josam.8054. DOI: https://doi.org/10.28982/josam.8054
Gulsen S and Baltacı A. Comparison of endoscopic transcanal and microscopic approach in Type 1 tympanoplasty. Brazilian Journal of Otorhinolaryngology. 2021 Mar; 87(2): 157-63. doi: 10.1016/j.bjorl.2019.07.005. DOI: https://doi.org/10.1016/j.bjorl.2019.07.005
Kumar P, Gulia JS, Arora N, Kumar B, Jangra P. Endoscopes as an alternative to microscopes for tympanoplasty: a comparative study. International Journal of Otorhinolaryngology and Head and Neck Surgery. 2024 Jul; 10(4): 1. doi: 10.18203/issn.2454-5929.ijohns20242042. DOI: https://doi.org/10.18203/issn.2454-5929.ijohns20242042
Kallyadan A, Sarkar S, Pradhan P, Karakkandy V, Parida PK, Chappity P et al. Endoscopic Tympanoplasty as an alternative to microscopic tympanoplasty: A comparative study on surgical outcomes and patient satisfaction. Indian Journal of Otolaryngology and Head & Neck Surgery. 2024 Feb; 76(1): 469-76. doi: 10.1007/s12070-023-04184-4. DOI: https://doi.org/10.1007/s12070-023-04184-4
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments