Comparison of microscopic and endoscopic approaches in transcanal tympanoplasty

Objective: In this study, we aimed to compare the superiority of microscopic and endoscopic methods in the surgical treatment of patients with tympanic membrane perforation in terms of postoperative objective and subjective parameters. Materials and Methods: Between December 2022 and June 2023, 61 patients aged 18-65 diagnosed with chronic otitis media and recommended for tympanoplasty surgery were included in our study at Necmettin Erbakan University Department of Otorhinolaryngology and Head and Neck Surgery. Transcanal tympanoplasty was performed using the microscopic method on 31 patients. For the remaining 30 patients, the procedure was done using the endoscopic method. Prior to the surgery, all patients underwent pure tone audiometry and temporal bone CT scans. On the first postoperative day, pain was recorded using the Visual Analog Scale (VAS) for pain. In the second postoperative month, hearing levels were recorded with pure tone audiometry, and graft success was documented with endoscopic images. Results: In our study, the demographic data of the patients in both groups were equally distributed, with no statistically significant difference (p > 0.05). The graft success rate in the microscopic tympanoplasty group was recorded as 86.7%, and 80.6% in the endoscopic tympanoplasty group (p = 0.525). The air-bone gap in pure tone audiometry decreased significantly in both the preoperative and postoperative periods for both groups (p < 0.001). Statistically, the change in the air-bone gap between the two surgical methods was found to be similar (p = 0.521). When comparing the pain scores (VAS) of the patients, there was no significant difference between the groups (p = 0.279). Conclusion: This study revealed that both tympanoplasty methods showed statistically similar results in terms of graft success rate and audiological data. Based on the objective and subjective outcomes of our study, the results of microscopic transcanal tympanoplasty are quite satisfactory. We concluded that it is equivalent to the results obtained with the endoscopic method, which is considered minimally invasive surgery. Keywords: tympanoplasty, transcanal, endoscope, microscope.