Abstract:
Aim of the study was to compare the surgical outcome of endoscopic with microscopic Type 1 tympanoplasty in dry, mucosal type of chronic otitis media with respect to graft uptake rate, hearing gain and duration of surgery. This randomized controlled trial of 3 years was carried out at Tertiary Care Hospital of Central India. Total 80 cases of mucosal type of chronic otitis media posted for Type I tympanoplasty were included in the study. They were randomly divided into two groups viz. Endoscopic tympanoplasty and microscopic tympanoplasty with 40 patients in each group. Chi-square test was used to compare the qualitative results and student\'s t-test was used to compare quantitative results with a level of significance of p ≤ 0.05. Intraoperatively, widening of external auditory canal and auxiliary incision were required in 45% and 47.5% patients of microscopic group respectively. Mean operative time for endoscopic tympanoplasty (62.5 ±14.94 mins) was less as compared to microscopic tympanoplasty (74.88 ± 15.83 mins). Graft uptake rate was 95% and 92.5% in endoscopic and microscopic tympanoplasty groups respectively with statistically insignificant difference (p = 0.32). The preoperative mean air bone gap in both the groups was improved significantly 6 months postoperatively. Air bone gap closure was of 13.21± 4.37 dB in endoscopic group and 12.54 ± 4.14 dB in microscopic group with statistically insignificant difference. Endoscope provides superior visualization of hidden areas of middle ear cavity and has shorter operative time than microscopic tympanoplasty with comparable surgical and functional outcomes. hence endoscopic tympanoplasty can be a good option to microscopic surgery.
摘要:
这项研究的目的是比较内镜下与显微镜下1型鼓室成形术在干燥,慢性中耳炎的粘膜类型相对于移植物摄取率,听力增益和手术持续时间。这项为期3年的随机对照试验在印度中部三级保健医院进行。该研究共纳入了80例用于I型鼓室成形术的粘膜型慢性中耳炎。他们被随机分为两组。内镜下鼓室成形术和显微镜下鼓室成形术各40例。采用卡方检验比较定性结果,采用t检验比较定量结果,显著性水平为p≤0.05。术中,显微镜组患者分别有45%和47.5%的患者需要扩大外耳道和辅助切口。与显微镜下鼓室成形术(74.88±15.83分钟)相比,内窥镜鼓室成形术的平均手术时间(62.5±14.94分钟)更短。内镜和显微镜下鼓室成形术组的移植物摄取率分别为95%和92.5%,差异无统计学意义(p=0.32)。术后6个月,两组术前平均气骨隙均有明显改善。内镜组空气骨间隙闭合为13.21±4.37dB,显微镜组12.54±4.14dB,差异无统计学意义。与显微鼓室成形术相比,内窥镜可提供中耳腔隐藏区域的出色可视化,并且手术时间短,具有可比的手术和功能结果。因此,内窥镜鼓室成形术是显微手术的一个很好的选择。