Endoscopic versus Microscopic Type 1 tympanoplasty – Comparison of surgical outcomes

Abstract

Objective

This study aims to compare the surgical outcomes of type 1 tympanoplasty performed with endoscopic and

microscopic techniques. It aims to compare the outcomes in terms of hearing restoration and graft success rates. It

also assesses differences in postoperative pain and operative time.

Methods

A prospective study conducted over 8 months included 84 patients, divided into two groups: 42 undergoing

microscopic tympanoplasty (postaural approach) and 42 undergoing endoscopic tympanoplasty (endomeatal

approach), using temporalis fascia graft. Preoperative and postoperative hearing were evaluated through pure tone

audiometry. Post operative hearing improvement and graft success was assessed at 3 months. Postoperative pain

was measured using a numerical rating scale at immediate and 1-week follow-ups.

Results

Both groups demonstrated similar graft success rates (microscopic 95.23%, endoscopic 92.86%) with no significant

difference in hearing improvement or air-bone gap closure. However, the endoscopic group had significantly

shorter operation times (mean 65.12 minutes) and less postoperative pain (immediate and at 1-week follow-up)

compared to the microscopic group (mean operation time 82.17 minutes, higher pain scores).

Conclusion

Endoscopic tympanoplasty offers comparable graft success and hearing outcomes to the microscopic approach

while providing the advantages of shorter operation time and reduced postoperative pain. These findings support

the growing preference for endoscopic techniques in minimally invasive middle ear surgeries.