COMPARATIVE EVALUATION OF THE FUNCTIONAL OUTCOMES AND QUALITY OF LIFE IN ENDOSCOPIC AND MICROSCOPIC TYMPANOPLASTY

Year 2025, Volume: 88 Issue: 4, 264 - 269, 30.10.2025

Said Sönmez , Hakan Kara , Berkay Çaytemel , Comert Sen , Beldan Polat

https://doi.org/10.26650/IUITFD.1721769

Abstract

Objective: This study aimed to compare endoscopic (Group 1) and microscopic (Group 2) tympanoplasty techniques in terms of sur gical success, functional outcomes, postoperative pain, and quality of life.

Material and Methods: Fortyfive patients who underwent tym panoplasty were retrospectively evaluated. Fifteen had endoscopic and 30 had microscopic surgery. Demographic data, surgical f indings, tympanic membrane integrity, operative time, hearing thresholds, and quality of life scores were analysed. Quality of life was assessed using the Chronic Otitis Media Questionnaire12 (COMQ12) preoperatively and the Chronic Otitis Media Benefit Inventory (COMBI) at the 6th postoperative month. Pain was mea sured using the Visual Analog Scale (VAS) at the 1st hour and 1st day after surgery. Hearing outcomes were evaluated through air conduction (AC), bone conduction (BC), and air bone gap (ABG) thresholds.

Results: There was no significant difference between the groups in operative time, membrane perforation, or membrane integrity at 6 months (Group 1: 100%, Group 2: 93.3%; p=0.54). Age differed significantly (p=0.039), while other demographics were similar. The quality of life scores (COMQ12 and COMBI) showed no significant difference. However, postoperative VAS scores were significantly lower in the endoscopic group at both time points (p<0.001). Both groups showed significant hearing improvement, with no statisti cal difference. The mean postoperative ABG was 6.88 dB in Group 1 and 7.44 dB in Group 2 (p=0.02).

Conclusion: Both techniques yielded similar anatomical and au ditory outcomes. However, the endoscopic approach reduced postoperative pain more effectively and may be preferred when patient comfort is a priority.

Keywords

Endoscopic tympanoplasty , microscopic tympanoplasty , COMQ12 , COMBI , hearing outcomes , quality of life

ENDOSKOPİK VE MİKROSKOPİK TİMPANOPLASTİ YÖNTEMLERİNİN FONKSİYONEL SONUÇLAR VE YAŞAM KALİTESİ AÇISINDAN KARŞILAŞTIRMALI DEĞERLENDİRMESİ

Abstract

Amaç: Bu çalışmada, endoskopik (Grup 1) ve mikroskopik (Grup 2) timpanoplasti tekniklerinin cerrahi başarı, fonksiyonel sonuçlar, postoperatif ağrı ve yaşam kalitesi açısından karşılaştırılması amaçlanmıştır.

Gereç ve Yöntemler: Timpanoplasti uygulanan toplam 45 hasta retrospektif olarak incelendi. On beş hastaya endoskopik, 30 hastaya mikroskopik cerrahi uygulandı. Demografik veriler, cerrahi bulgular, timpanik membran bütünlüğü, ameliyat süresi, işitme eşikleri ve yaşam kalitesi skorları analiz edildi. Yaşam kalitesi, preoperatif dönemde COMQ12 ve postoperatif 6. ayda COMBI anketleri ile değerlendirildi. Postoperatif ağrı düzeyleri, ameliyattan sonraki 1. saatte ve 1. günde Görsel Analog Skala (VAS) ile ölçüldü. İşitme sonuçları, hava yolu (AC), kemik yolu (BC) ve hava kemik aralığı (ABG) ile değerlendirildi.

Bulgular: Ameliyat süresi, timpanik membran perforasyonu ve 6. aydaki membran bütünlüğü açısından gruplar arasında anlamlı fark yoktu (Grup 1: %100, Grup 2: %93,3; p=0,54). Yaş grupları arasında fark vardı (p=0,039), diğer demografik veriler benzerdi. Yaşam kalitesi skorları (COMQ12 ve COMBI) açısından anlamlı fark saptanmadı. Ancak postoperatif VAS skorları her iki zaman noktasında endoskopik grupta anlamlı olarak daha düşüktü (p<0,001). Her iki grupta da işitme belirgin şekilde iyileşti, ancak gruplar arasında istatistiksel fark bulunmadı. Ortalama postoperatif ABG Grup 1’de 6,88 dB, Grup 2’de 7,44 dB idi (p=0,02).

Sonuç: Her iki teknik anatomik ve işitsel başarı açısından benzer sonuçlar vermiştir. Ancak endoskopik yaklaşım, postoperatif ağrıyı azaltma açısından daha üstündür ve hasta konforunun ön planda tutulduğu durumlarda tercih edilebilir.

Keywords

Endoskopik timpanoplasti , mikroskopik tim panoplasti , COMQ12 , COMBI , işitme sonuçları , yaşam kalitesi

References

• Bianchini AJ, Berlitz VG, Mocelin AG, Ribeiro JF, Keruk JG, Hamerschmidt R. Endoscopic or microscopic tympanoplasty advantages and disadvantages: a theory domain systematic review. Int Arch Otorhinolaryngol 2023;27(03):e528-35. google scholar
• Tarabichi M. Endoscopic management of cholesteatoma: long-term results. Otolaryngol Head Neck Surg 2000;122(6):874-81. google scholar
• Marchioni D, Gazzini L, De Rossi S, Di Maro F, Sacchetto L, Carner M, et al. The management of tympanic membrane perforation with endoscopic type I tympanoplasty. Otol Neurotol 2020;41(2):214-21. google scholar
• Pap I, Tóth I, Gede N, Hegyi P, Szakács Z, Koukkoullis A, et al. Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—A meta‐analysis. Clin Otolaryngol 2019;44(6):942-53. google scholar
• Ayache S. Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol 2013;270(3):853-60. google scholar
• Kuo C-h, Wu H-m. Comparison of endoscopic and microscopic tympanoplasty. Eur Arch Otorhinolaryngol 2017;274:2727-32. google scholar
• Crotty TJ, Cleere EF, Keogh IJ. Endoscopic versus microscopic type‐ 1 tympanoplasty: A meta‐analysis of randomized trials. Laryngoscope 2023;133(7):1550-7. google scholar
• Emre IE, Cingi C, Muluk NB, Nogueira JF. Endoscopic ear surgery. J Otol 2020;15(1):27-32. google scholar
• Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: a systematic review and meta‐analysis. Laryngoscope 2017;127(8):1890-6. google scholar
• Choi N, Noh Y, Park W, Lee JJ, Yook S, Choi JE, et al. Comparison of endoscopic tympanoplasty to microscopic tympanoplasty. Clin Exp Otorhinolaryngol 2017;10(1):44-9. google scholar
• Kallyadan A, Sarkar S, Pradhan P, Karakkandy V, Parida PK, Chappity P, et al. Endoscopic Tympanoplasty as an alternative to microscopic tympanoplasty: A comparative study on surgical outcomes and patient satisfaction. Indian J Otolaryngol Head Neck Surg 2024;76(1):469-76. google scholar
• Nassif N, Berlucchi M, de Zinis LOR. Tympanic membrane perforation in children: endoscopic type I tympanoplasty, a newly technique, is it worthwhile? Int J Pediatr Otorhinolaryngol 2015;79(11):1860-4. google scholar
• Artham P, Mishra P, Gaiakwad V, Chethana R, Seal S, Sinha A. Comparison of Endoscopic Versus Microscopic Tympanoplasty: A Prospective Randomised Study. Indian J Otolaryngol Head Neck Surg 2024;76(4):3037-40. google scholar
• Elnahal KB, Hassan MA, Maarouf AM. Comparison of endoscope-assisted and microscope-assisted type I tympanoplasty; a systematic review and meta- analysis. Eur Arch Otorhinolaryngol 2024;281(5):2243-52. google scholar
• Presutti L, Nogueira JF, Alicandri-Ciufelli M, Marchioni D. Beyond the middle ear: endoscopic surgical anatomy and approaches to inner ear and lateral skull base. Otolaryngol Clin North Ame 2013;46(2):189-200. google scholar
• Shakya D, Arun K, Nepal A. A comparative study of endoscopic versus microscopic cartilage type I tympanoplasty. Int Arch Otorhinolaryngol. 2020;24(01):e80-5. google scholar
• Pap I, Kovács M, Bölcsföldi B, Szakács Z, Gerlinger I, Imreh B, et al. Quality- of-life outcomes with endoscopic and microscopic type I tympanoplasty—a prospective cohort study. Eur Arch Otorhinolaryngol 2023;280(10):4401-8. google scholar