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Abstract：
BACKGROUND This prospective study aimed to compare outcomes and hearing improvement in 51 patients with adhesive otitis media following endoscopic and microscopic tympanoplasty. MATERIAL AND METHODS Between April 2021 and April 2022, 51 patients diagnosed with pars tensa retraction and hearing loss who underwent endoscopic and microscopic cartilage tympanoplasty were included in the study (endoscopic tympanoplasty group: 26 patients, microscopic tympanoplasty group: 25 patients). Pure-tone audiometric data (0.5, 1, 2, and 4 kHz), air-bone gap (ABG), and postoperative graft intake were compared. RESULTS Hearing gain in the ABG was significant in both groups (p<0.05). When the groups were compared for mean hearing gain in the ABG, the difference was significant (p<0.05). The postoperative ABG in the endoscopic group was significantly smaller than that in the microscopic group. When the postoperative air conduction threshold was evaluated, there was no significant difference between the 2 groups at 4 kHz, whereas a significant difference was observed in the endoscopic tympanoplasty group at 0.5, 1, and 2 kHz. Postoperative graft failure and otorrhea were not observed in any of the patients. CONCLUSIONS Pars tensa retractions and adhesive otitis media show comparable outcomes with both endoscopic and microscopic techniques. In endoscopic tympanoplasty, better visualization allows for better hearing outcomes. The endoscopic method, characterized by a wide field of view and a less invasive approach, enhances access to retraction limits.
摘要：
背景这项前瞻性研究旨在比较51例粘连性中耳炎患者在内镜和显微镜下鼓室成形术后的疗效和听力改善情况。材料与方法在2021年4月至2022年4月之间，将51例诊断为经鼻内镜和显微镜下软骨鼓室成形术的肌腱部回缩和听力损失的患者纳入研究（内镜鼓室成形术组：26例，镜下鼓室成形术组：25例患者）。纯音测听数据（0.5、1、2和4kHz），空气-骨间隙（ABG），和术后移植物摄入量进行比较。结果两组的ABG听力增益均显著(p<0.05)。当比较两组的平均听力增益时，差异有统计学意义(p<0.05)。内镜组术后ABG明显小于显微镜组。当评估术后空气传导阈值时，两组在4kHz时无显著差异,而在内镜鼓室成形术组在0.5、1和2kHz时观察到显著差异。在任何患者中均未观察到术后移植失败和耳漏。结论采用内窥镜和显微技术，肌腱部缩回和粘连性中耳炎显示出相当的结果。在内窥镜鼓室成形术中，更好的可视化允许更好的听力结果。内窥镜方法，具有广阔的视野和较小的侵入性方法，增强了对缩回限制的访问。
