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

Öz

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.

Anahtar Kelimeler

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

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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