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Comparative Study between Endoscopic Transcanal Myringoplasty Versus Microscopic Myringoplasty in middle age group (20-40 years)

Background: The surgical goals of myringoplasty are the closure of the tympanic membrane perforation and improvement of the hearing levels. Aim of the work: To compare the results, advantages and disadvantages between endoscope and microscope in myringoplasty. PATIENTS AND METHODS: This study was carried out in the Otorhinolaryngology Department at Alhussin and Bab-Alsharia University Hospitals. The study included 40 patients with a diagnosis of chronic suppurative otitis media of tubo-tympanic type, divided into two groups and each group contained 20 patients. All patients were operated by one surgeon. Results: The difference in age, sex, side of diseased ear and size of perforation between the two groups was not significant. In group (A) the circumference of the perforation was clearly visualized in all patients (100%). While, in group (B) the circumference of the perforation could not be visualized in 7 patients (35%), 5 patients (25%) required external auditory canal curettage and 2 patients (10%) required endoscope-assisted microscopic myringoplasty to evaluate the ossicular chain. The difference between the 2 groups was significant (P.value = 0.004). In group (A) the graft was uptaken in 85% of patients while in group (B) the graft was uptaken in 80% of patients with no significant difference between the two groups (p = 0.677). Conclusion: The ability to easily negotiate through EAC, Panoramic, wide angle, and magnified view provided by the endoscope and uninterrupted picture overcomes most of the disadvantage of the microscope.