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  3. 25. Surgical Management of Chronic Suppurative Otitis Media; A Cross sectional Comparative Study Between Microscopic and Endoscopic Tympanoplasty
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25. Surgical Management of Chronic Suppurative Otitis Media; A Cross sectional Comparative Study Between Microscopic and Endoscopic Tympanoplasty

Tahir Hussain Khan1, Ashfaq Hussain Rana2 and Sohail A. Malik1

ABSTRACT

Objective: To compare the surgical outcomes of Microscopic and Endoscopic Tympanoplasty.

Study Design: Observational/ cross sectional study.

Place and Duration of Study: This study was conducted at the two different hospitals. 1- Al-Tibri Medical College and hospital karachi and Social security Landhi hospital Karachi from July 2017 to June 2018.

Materials and Methods: 76 Patients of both genders were included in this study who had dry tympanic membrane perforations. Age ranges were 18-40 years. Patients were divided in two groups A and B. 38 patients in each group. In group A, Microscopic Tympanoplasty was performed with temporalis fascia graft via post aural approach. In group B, Endoscopic tympanoplasty was performed with the help of tragal cartilage/perichondrium graft via per meatal approach. Observed outcomes of both procedure after 1 day, after 1 week, after 1 month and after 2 months. Variable were pain, bleeding, hearing assessment with PTA in which measured air conduction, bone conduction and AB gap (Air-Bone), duration of surgery, vomiting and vertigo.

Results: 37 patients out of 38 had intact grafted tympanic membrane in group A (M.T.) while all 38 patients had intact grafted tympanic membrane in group B (E.T.). Bleeding was less in group B, as compare to group A. There was no blood-soaked gauze in endoscopic tympanoplasty group. Mean duration of surgery was in endoscopic tympanoplasty group 65.1 + 3.7 minutes and mean duration of microscopic tympanoplasty was 82.0 + 5.6 minutes. P value was < 0.001 is significant. Duration of surgery was less in endoscopic tympanoplasty. Hearing was also improved in both groups after tympanoplasty. Post- operative AB gap reduction seen in all patients in both groups. Weber test performed 1st post -operative day it was lateralized towards operated ear which indicate integrity of inner ear. Vomiting and vertigo not present after tympanoplasty in both groups which indicate the safety of vestibular system.

Conclusion: Results of both Microscopic and Endoscopic Tympanoplasty were almost same but endoscopic tympanoplasty is better because this procedure consumed less time, less post- operative pain, less post- operative bleeding and no scar after surgery.

Key Words: Surgical Management, Chronic Suppurative Otitis Media; Microscopic, Endoscopic Tympanoplasty

Citation of articles: Khan TH, Rana AH, Malik SA. Surgical Management of Chronic Suppurative Otitis Media; A Cross sectional Comparative Study Between Microscopic And Endoscopic Tympanoplasty. Med Forum 2019;20(1):106-110.