Is Endoscopic Tympanoplasty an Alternative to Microscopic Tympanoplasty for Small Central Perforations? A Study

Introduction: Traditional approaches to tympanoplasty involve the use of a microscope. However, with the advent of endoscopes and HD cameras, endoscopic tympanoplasty has appeared as an alternative to microscopic tympanoplasty. Our study was aimed at assessing the success rates of endoscopic tympanoplasty in small dry central perforations of pars tensa. Materials and Methods: 49 patients were enrolled in this study for undergoing endoscopic tympanoplasty and the surgical outcome was analyzed in terms of graft uptake and postoperative air-bone gap closure for 6 months. Results: Among the study population, 45 participants (91.84%) had an intact neotympanum at the end of 6 months, two participants (4.08%) had residual perforation, and two (4.08%) had recurrent perforations due to upper respiratory tract infection. The mean preoperative air-bone gap (AB gap) was 23.63 dB ± 3.9 dB in the study population with a minimum of 16 dB and a maximum of 31 dB (95% confidence interval [CI] 22.43–24.83), whereas the mean postoperative AB gap was 13.84 dB ± 2.79 dB, minimum being 8 dB and maximum being 20 dB (95% CI 12.98–14.69). The difference between the preoperative and postoperative air-bone gap was statistically significant (P < 0.001). Conclusions: We conclude that the endoscopic myringoplasty is an attractive alternative to conventional microscopic myringoplasty in terms of surgical outcomes, graft uptake, and air-bone gap closure.