COMPARISON OF ENDOSCOPIC EAR SURGERY AND MICROSCOPIC EAR SURGERY IN PATIENTS WITH ATTIC CHOLESTEATOMA

The study aimed to compare the effectiveness of microscopic and endoscopic approaches in treating attic cholesteatoma, a condition where abnormal skin growth occurs in the middle ear. The research was conducted prospectively at the ENT Department of Nishtar Medical Hospital from January 2021 to January 2023 on 70 patients with chronic suppurative otitis media with cholesteatoma in the epitympanic region. The patients were randomly divided into two groups, with 35 in each group. Both groups were followed up post-operatively at 1st, third, and sixth months, and their hearing was assessed. The study found that five patients (14.2%) in the endoscopic ear surgery (EES) group and three patients (8.5%) in the microscopic ear surgery (MES) group had suspected facial nerve dehiscence according to pre-operative CT images. During the surgery, 11 patients (35%) in the ESS group and seven (20%) in the MES group showed facial nerve dehiscence. Post-operatively, abnormal taste sensation was reported in 28.5% of cases in the EES group and 42.8% in the MES group. The mean postoperative air conduction thresholds in both groups were not significantly different. The success rate was 100% in both groups, and there was no disease recurrence in either group. It was concluded that the surgical outcomes of the conventional microscopic approach and endoscopic ear surgery are comparable regarding taste sensation, post-operative air conduction, and graft success rate. However, ESS showed better results regarding healing time and post-operative pain. Microscopic surgery was significantly slower than endoscopic surgery. In contrast, the average healing time in the endoscopic group was faster than in the microscopic group.