Endoscopic versus microscopic approach in the treatment of atelectatic otitis media

Acta Otolaryngol. 2024 Nov-Dec;144(11-12):592-601. doi: 10.1080/00016489.2024.2424947. Epub 2024 Nov 25.

Abstract

Background: endoscopic ear surgery in patients Chronic Otitis Media(COM) media with eardrum atelectasis.

Objective: to compare the postoperative outcomes and audiological results of the endoscopic approach versus the microscopic approach for treatment of COM media with eardrum atelectasis, using a randomized prospective model.

Methods: Sixty patients were consecutively enrolled in the study and randomized into two groups: Group A 32 patients underwent canal wall up tympanoplasty (CWA); Group B 28 patients underwent tympanoplasty with an exclusive trans-meatal endoscopic approach. Audiological results and preoperative, intraoperative and postoperative outcomes were evaluated.

Results: No statistical difference emerged between distribution of middle ear atelectasis patients grade 3 and 4 between the two surgical groups (p > 0.05). The group B appeared to have shorter surgical times than group A (69.8 min vs. 88.9 min). The graft success rate was estimated in 90.6% and 92.8% in group A and B respectively, without statistical differences between groups (p = 1). The Overall success rate was therefore calculated in 87.5% and 92.8% for both groups.

Conclusion and significance: Endoscopic ear surgery could be a suitable approach for treating COM media with eardrum atelectasis with similar results compared with the Microscopic surgery.

Keywords: Middle ear atelectasis; endoscopic ear surgery; middle ear endoscopy; tympanic membrane retraction.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Chronic Disease
  • Endoscopy* / methods
  • Female
  • Humans
  • Male
  • Microsurgery / methods
  • Middle Aged
  • Otitis Media* / surgery
  • Prospective Studies
  • Treatment Outcome
  • Tympanoplasty* / methods
  • Young Adult