Publication:

Tympanoplasty revolutionized: my experience with a series of 500 cases

Background Tympanoplasty has been the mainstay in management of chronic suppurative otitis media for decades with invent of microscopes in ear surgeries, which traditionally have been giving good results when in good hands. However, after the introduction of endoscopes in the field of otology, it has completely revolutionized my outlook and approach to the pathophysiology of the disease as well as its management. The aim of the present study was to discuss the advantages of endoscopes over microscopes and the science of endoscopic minimally invasive middle ear surgery.

Methods A retrospective study was conducted on 500 cases where we did endoscopic endomeatal tympanoplasty for chronic suppurative otitis media – mucosal type with central perforation, between May 1996 and May 2017 in our tertiary medical centre.

Results Among 500 cases operated, 99 % of our cases had excellent graft take up. Pure tone audiometry done before and after 2 month of surgery showed an improvement in the conductive hearing with reduced air bone gap. 97% patients with moderate conductive hearing loss had their hearing within normal limit postoperatively. Endoscope provided better visualization, avoided canalplasty, reduced operative time, shorter hospital stay and was cost effectiveConclusions: Minimally invasive endoscopic tympanoplasty provided better visualization, avoided canalplasty, reduced operative time, shorter hospital stay and was cost effective and thereby finds itself at a futuristic level over microscopes. Nevertheless, it does require a long learning curve, and experience to expertise for optimal patient satisfaction and overcome complications.