Comparison of clinical and audiological results of transcanal endoscopic and retroauricular microscopic approaches in patients who underwent tympanoplasty

Introduction and Aim: Tympanoplasty is a surgical procedure aimed at restoring middle ear function, typically performed in the treatment of conditions such as chronic otitis media (COM), involving both myringoplasty and ossiculoplasty. This study aims to compare the clinical and audiological outcomes of transcanal endoscopic and retroauricular microscopic approaches in patients undergoing type 1 tympanoplasty. The study evaluates both approaches in terms of postoperative hearing improvement, surgery duration, success rates, postoperative pain, and complication rates to determine which surgical method is more effective and to identify any potential superiority of one approach over the other. Materials and Methods: A retrospective cohort study was conducted on 86 patients who underwent either endoscopic or microscopic tympanoplasty at the Karadeniz Technical University Farabi Hospital, Department of Otolaryngology, between January 1, 2017, and January 1, 2023. Patients were matched 1:1 and evaluated for preoperative and postoperative hearing levels, along with surgical outcomes. Results: Both surgical techniques resulted in improvements across all frequencies post-tympanoplasty. The presence of additional pathologies was associated with an increase in surgery duration. It was observed that 77.9% of patients had hearing loss, 67.4% had posterior perforation, and 20.9% had additional pathologies. The average hospital stay was 2.6 days (±0.9 days), and the average surgery duration was 115.87 minutes (±20.09 minutes). The surgeries were successful in 90.7% of the cases, with a complication rate of 5.81%. Endoscopic surgeries had shorter operative times, less postoperative pain, and higher success rates than microscopic surgeries. Conclusion: The endoscopic technique demonstrated advantages such as shorter operative time, higher success rate, and lower postoperative pain. However, there was no significant superiority of one surgical technique over the other in terms of hearing improvement. Keywords: Tympanoplasty, Endoscopic Surgery, Audiological Outcomes.