Comparative study of conventional tympanoplasty versus endoscopic tympanoplasty

Introduction: Conventional microscopic Tympanoplasty with a Postauricular incision is a procedure for patients with chronic otitis media safe type. In our study unsafe chronic otitis media in not included. Minimally invasive otologic surgery has recently been developed along with endoscopic techniques. Endoscopic ear surgery, first tried in the 1990s3 has become popular with anatomic and physiologic concepts4. Endoscopically, the typical transcanal approach. This avoids other unnecessary incisions and soft tissue dissections. The endoscopic approach also provides better visualization of hidden areas in the middle ear cavity including the anterior and posterior epitympanic spaces, sinus tympani, facial recess, and hypotympanum. Material and Method: Total 80 cases satisfying the inclusion criteria were enrolled in study. Detailed history was taken in every case including ear discharge decreased hearing , tinnitus , giddiness, trauma , nasal complaints .Detailed clinical and systemic examination was done in each case. Each patient was investigated as per proforma clinical, audiometric, radiological examination. After pre Anaesthetic check-up, patient is admitted and posted for tympanoplasty surgery.In our study, we have done comparative study of conventional (microscopic) and endoscopic tympanoplasty. Selection of patients for particular treatment modality is done with randomized method. We have used preoperative antibiotics, antihistaminic, antacid, antiemetics, and nasal decongestant drop. Regarding the anaesthesia most of cases are done in local anaesthesia with sedation, few cases are done in general anaesthesia. Conclusion: After a detailed discussion and comparison with literature, we conclude thatEndoscopic tympanoplasty as a technique has a long learning curve. Endoscopic technique is as efficacious as and less invasive than microscope surgery. Endoscopic technique of tympanoplasty can yield similar result as microscopic technique with better cosmetics and less pain. Post-operative hearing also shows almost similar result. Surgical time is less for endoscopic than conventional tympanoplasty. Graft uptake rate is more for endoscopic than conventional tympanoplasty