Abstract：
OBJECTIVE: To analyze the outcomes of exoscopic versus microscopic type 1 tympanoplasty.
METHODS: Retrospective chart review.
METHODS: Tertiary care otology-neurotology practice.
METHODS: Adult subjects with a diagnosis of tympanic membrane perforation from 2018 to 2022.
METHODS: Exoscopic or microscopic tympanoplasty with cartilage + perichondrium or perichondrium/fascia graft.
METHODS: Primary outcomes were graft success rate (1 wk, 3 wk, 3 mo, and 6 mo postoperatively) and operative time. Secondary outcomes included audiometric outcomes of postoperative air-bone gap (ABG), change in ABG, pure tone average (PTA), speech reception threshold (SRT), and word recognition score (WRS) at 6-month follow-up and complication rates of cerebrospinal fluid leak, facial nerve injury, persistent tinnitus, and persistent vertigo.
RESULTS: Seventy-one patients underwent type 1 tympanoplasty by a single surgeon. Thirty-six patients underwent exoscopic tympanoplasty, and 35 patients underwent microscopic tympanoplasty. Cartilage and perichondrium were utilized in 27 subjects (75.0%) in the exoscopic group and in 25 subjects (71.4%) in the microscopic group (p = 0.7, Cramer\'s V = 0.04). Graft success rate was as follows (exoscope versus microscope): 100% (36/36) versus 100% (35/35) at 1 week (p = 1.0, Cramer\'s V = 0.0), 97.2% (35/36) versus 100% (35/35) at 3 weeks (p = 1.0, Cramer\'s V = 0.1), 97.2% (35/36) versus 94.3% (33/35) at 3 months (p = 1.0, Cramer\'s V = 0.07), and 91.7% (33/36) versus 91.4% (32/35) at 6 months (p = 0.7, Cramer\'s V = 0.0). Operative time was 57.7 minutes for the exoscopic group and 65.4 minutes for the microscopic group (p = 0.08, 95% CI [-16.4, 0.9], Cohen\'s d = 0.4). There were no serious complications. All preoperative and postoperative audiometric outcomes were comparable.
CONCLUSIONS: The outcomes after exoscopic versus microscopic type 1 tympanoplasty are comparable.
METHODS: Retrospective chart review.
METHODS: Tertiary care otology-neurotology practice.
METHODS: Adult subjects with a diagnosis of tympanic membrane perforation from 2018 to 2022.
METHODS: Exoscopic or microscopic tympanoplasty with cartilage + perichondrium or perichondrium/fascia graft.
METHODS: Primary outcomes were graft success rate (1 wk, 3 wk, 3 mo, and 6 mo postoperatively) and operative time. Secondary outcomes included audiometric outcomes of postoperative air-bone gap (ABG), change in ABG, pure tone average (PTA), speech reception threshold (SRT), and word recognition score (WRS) at 6-month follow-up and complication rates of cerebrospinal fluid leak, facial nerve injury, persistent tinnitus, and persistent vertigo.
RESULTS: Seventy-one patients underwent type 1 tympanoplasty by a single surgeon. Thirty-six patients underwent exoscopic tympanoplasty, and 35 patients underwent microscopic tympanoplasty. Cartilage and perichondrium were utilized in 27 subjects (75.0%) in the exoscopic group and in 25 subjects (71.4%) in the microscopic group (p = 0.7, Cramer\'s V = 0.04). Graft success rate was as follows (exoscope versus microscope): 100% (36/36) versus 100% (35/35) at 1 week (p = 1.0, Cramer\'s V = 0.0), 97.2% (35/36) versus 100% (35/35) at 3 weeks (p = 1.0, Cramer\'s V = 0.1), 97.2% (35/36) versus 94.3% (33/35) at 3 months (p = 1.0, Cramer\'s V = 0.07), and 91.7% (33/36) versus 91.4% (32/35) at 6 months (p = 0.7, Cramer\'s V = 0.0). Operative time was 57.7 minutes for the exoscopic group and 65.4 minutes for the microscopic group (p = 0.08, 95% CI [-16.4, 0.9], Cohen\'s d = 0.4). There were no serious complications. All preoperative and postoperative audiometric outcomes were comparable.
CONCLUSIONS: The outcomes after exoscopic versus microscopic type 1 tympanoplasty are comparable.
摘要：
目的：分析镜下1型鼓室成形术与镜下1型鼓室成形术的疗效。
方法：回顾性图表回顾。
方法：三级护理耳科学-神经实践。
方法：2018年至2022年诊断为鼓膜穿孔的成年受试者。
方法：采用软骨+软骨膜或软骨膜/筋膜移植的外镜或显微镜下鼓室成形术。
方法：主要结果是移植物成功率（1周，3周,3mo,术后6个月）和手术时间。次要结果包括术后气-骨间隙（ABG）的听力测定结果，ABG的变化，纯音平均（PTA），语音接收阈值(SRT)，6个月随访时的单词识别评分（WRS）和脑脊液漏的并发症发生率，面神经损伤,持续性耳鸣,和持续性眩晕。
结果：71例患者由一名外科医生接受了1型鼓室成形术。36例患者接受了腹腔镜鼓室成形术，35例患者接受显微鼓室成形术。外镜组27例（75.0％）和显微镜组25例（71.4％）使用了软骨和软骨膜（p=0.7，Cramer\sV=0.04）。移植成功率如下（外镜与显微镜）：1周时100％（36/36）对100％（35/35）（p=1.0，Cramer\sV=0.0），97.2％（35/36）与100％（35/35）在3周（p=1.0，CramerV=0.1），97.2％（35/36）与94.3％（33/35）在3个月（p=1.0，CramerV=0.07），6个月时分别为91.7%(33/36)和91.4%(32/35)(p=0.7，Cramer\sV=0.0)。手术时间镜组为57.7分钟，镜组为65.4分钟（p=0.08,95%CI[-16.4,0.9]，科恩的d=0.4）。无严重并发症。所有术前和术后听力测量结果具有可比性。
结论：镜下1型鼓室成形术后的结果相当。
方法：回顾性图表回顾。
方法：三级护理耳科学-神经实践。
方法：2018年至2022年诊断为鼓膜穿孔的成年受试者。
方法：采用软骨+软骨膜或软骨膜/筋膜移植的外镜或显微镜下鼓室成形术。
方法：主要结果是移植物成功率（1周，3周,3mo,术后6个月）和手术时间。次要结果包括术后气-骨间隙（ABG）的听力测定结果，ABG的变化，纯音平均（PTA），语音接收阈值(SRT)，6个月随访时的单词识别评分（WRS）和脑脊液漏的并发症发生率，面神经损伤,持续性耳鸣,和持续性眩晕。
结果：71例患者由一名外科医生接受了1型鼓室成形术。36例患者接受了腹腔镜鼓室成形术，35例患者接受显微鼓室成形术。外镜组27例（75.0％）和显微镜组25例（71.4％）使用了软骨和软骨膜（p=0.7，Cramer\sV=0.04）。移植成功率如下（外镜与显微镜）：1周时100％（36/36）对100％（35/35）（p=1.0，Cramer\sV=0.0），97.2％（35/36）与100％（35/35）在3周（p=1.0，CramerV=0.1），97.2％（35/36）与94.3％（33/35）在3个月（p=1.0，CramerV=0.07），6个月时分别为91.7%(33/36)和91.4%(32/35)(p=0.7，Cramer\sV=0.0)。手术时间镜组为57.7分钟，镜组为65.4分钟（p=0.08,95%CI[-16.4,0.9]，科恩的d=0.4）。无严重并发症。所有术前和术后听力测量结果具有可比性。
结论：镜下1型鼓室成形术后的结果相当。
