Outcomes After Exoscopic Versus Microscopic Type 1 Tympanoplasty.

Document Type

Article

Publication Date

7-1-2024

Publication Title

Otology & neurotology

Abstract

OBJECTIVE: To analyze the outcomes of exoscopic versus microscopic type 1 tympanoplasty.

STUDY DESIGN: Retrospective chart review.

SETTING: Tertiary care otology-neurotology practice.

PATIENTS: Adult subjects with a diagnosis of tympanic membrane perforation from 2018 to 2022.

INTERVENTION: Exoscopic or microscopic tympanoplasty with cartilage + perichondrium or perichondrium/fascia graft.

MAIN OUTCOME MEASURES: Primary outcomes were graft success rate (1 wk, 3 wk, 3 mo, and 6 mo postoperatively) and operative time. Secondary outcomes included audiometric outcomes of postoperative air-bone gap (ABG), change in ABG, pure tone average (PTA), speech reception threshold (SRT), and word recognition score (WRS) at 6-month follow-up and complication rates of cerebrospinal fluid leak, facial nerve injury, persistent tinnitus, and persistent vertigo.

RESULTS: Seventy-one patients underwent type 1 tympanoplasty by a single surgeon. Thirty-six patients underwent exoscopic tympanoplasty, and 35 patients underwent microscopic tympanoplasty. Cartilage and perichondrium were utilized in 27 subjects (75.0%) in the exoscopic group and in 25 subjects (71.4%) in the microscopic group (p = 0.7, Cramer's V = 0.04). Graft success rate was as follows (exoscope versus microscope): 100% (36/36) versus 100% (35/35) at 1 week (p = 1.0, Cramer's V = 0.0), 97.2% (35/36) versus 100% (35/35) at 3 weeks (p = 1.0, Cramer's V = 0.1), 97.2% (35/36) versus 94.3% (33/35) at 3 months (p = 1.0, Cramer's V = 0.07), and 91.7% (33/36) versus 91.4% (32/35) at 6 months (p = 0.7, Cramer's V = 0.0). Operative time was 57.7 minutes for the exoscopic group and 65.4 minutes for the microscopic group (p = 0.08, 95% CI [-16.4, 0.9], Cohen's d = 0.4). There were no serious complications. All preoperative and postoperative audiometric outcomes were comparable.

CONCLUSIONS: The outcomes after exoscopic versus microscopic type 1 tympanoplasty are comparable.

Volume

45

Issue

6

First Page

671

Last Page

675

DOI

10.1097/MAO.0000000000004220

ISSN

1537-4505

PubMed ID

38865726

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