Abstract
Objective: To compare Audiological outcomes of endoscopic and microscopic tympanoplasty by assessing postoperative air conduction, bone conduction, and air–bone gap improvement
Material & Methods: A cross-sectional study was conducted at the ENT and Surgical Department, Mayo Hospital Lahore, who underwent Type I endoscopic or microscopic tympanoplasty. Audiological outcomes, graft success, operative time, postoperative complications, and hospital stay were compared between the two techniques. Data were analyzed using SPSS version 20.0, with p < 0.05 considered statistically significant.
Results: A total of 240 patients were included, with comparable baseline age, gender, perforation size, and revision status between the endoscopic and microscopic tympanoplasty groups (p > 0.05). Significant differences were observed only in disease laterality, perforation location, and anesthesia type (p < 0.05). Preoperative audiological parameters were largely similar between groups, except for operative-side speech discrimination score and low-tone hearing threshold. Both surgical techniques produced significant postoperative improvements in air conduction, air–bone gap, and low- and high-tone hearing thresholds (all p < 0.05), while bone conduction thresholds remained unchanged. The endoscopic group demonstrated a higher graft success rate than the microscopic group (93.3% vs. 86.7%), although the difference was not statistically significant (p = 0.083). Rates of re-perforation, otorrhea, otalgia, and wound infection were comparable between groups (all p > 0.05). However, endoscopic tympanoplasty was associated with a significantly shorter operative time (80.11 ± 10.81 vs. 95.01 ± 17.21 minutes; p < 0.001) and a shorter hospital stay (5.12 ± 2.01 vs. 8.09 ± 1.27 days; p < 0.001).
Conclusion: The audiological outcomes of Type I endoscopic tympanoplasty were comparable to those of microscopic tympanoplasty, with no significant differences in hearing improvement between the two techniques. However, endoscopic tympanoplasty was associated with a significantly shorter operative time and reduced length of hospital stay, indicating greater surgical efficiency while maintaining similar clinical outcomes.