Comparison of Outcomes of Endoscopic Versus Microscopic Myringoplasty: A Tertiary Centre Experience

By June 7, 2019

Tan, Charmaine1; Murugasu, Euan2
1 Department of Otolaryngology, Head and Neck Surgery, National University Health System, Singapore;
2 Department of Otolaryngology, Head and Neck Surgery, Ng Teng Fong General Hospital, Singapore.

Endoscopic ear surgery has gained popularity over the years, offering wide-angle, magnified views of the middle ear, and avoidance of external incisions. This study aims to evaluate outcomes of endoscopic myringoplasty in comparison to conventional microscopic myringoplasty.

A retrospective chart review was performed for 101 patients with chronic otitis media who underwent myringoplasty at Ng Teng Fong General Hospital, Singapore, from July 2015 to December 2018. 63 patients underwent myringoplasty via endoscopic approach, 38 patients via microscopic approach. Demographic data, pre-operative findings, graft placement technique, duration of surgery, length of hospitalization, post-operative follow-up and audiometric data were evaluated.

Primary outcome measure was graft success. Secondary outcome measures included surgery duration, need for canalplasty and/or meatoplasty, and post-operative hearing gain. Graft success was 80.95% for endoscopic and 81.58% for microscopic groups (p=0.938). There was no significant difference in length of hospitalization (96.83% of endoscopic and 94.71% of microscopic groups staying up to 1-day, p=0.142). 10 of 38 patients and 14 of 38 patients from the microscopic group required canalplasty and meatoplasty respectively (none from endoscopic group). There was significant difference in duration of surgery (average duration was 43minutes less in the endoscopic group). Both groups had reduced air-bone gaps post-operatively, but there was no statistically significant difference in hearing gain between groups (p=0.116). The study shows that endoscopic approach for myringoplasty offers comparable outcomes to microscopic myringoplasty in graft success, with benefits of shorter surgery duration and avoidance of external incisions, additional canalplasty and meatoplasty procedures for access.