Abstract
Background and Objectives: Myringoplasty is a surgical technique to repair a perforated tympanic membrane in cases of chronic suppurative otitis media. This study evaluates the effectiveness of endoscopic versus microscopic myringoplasty in improving hearing among these patients.
Methods: This randomized clinical study, approved by the local ethics board, included patients with chronic suppurative otitis media and dry tympanic membrane perforation scheduled for myringoplasty at Rizgary Teaching Hospital in Erbil from January 2023 to January 2024. Sixty patients were randomly assigned to undergo myringoplasty, with half undergoing endoscopic myringoplasty and the other half (30 patients) undergoing microscopic myringoplasty. Postoperative hearing outcomes (air conduction thresholds and the air-bone gap) were evaluated using pure-tone audiometry preoperatively and three months postoperatively. Data analysis was conducted using SPSS Statistics version 22.
Results: The study included 60 patients (mean age: 34.6 ± 13.5 years, 63.3% male). Preoperative pure-tone audiometry (PTA) results, including both air conduction thresholds and the air-bone gap, were similar between the two techniques (P > 0.05). However, three-month postoperative results favored the microscopic group, showing significant improvements in air conduction threshold (P = 0.039) and air-bone gap (P = 0.016). The microscopic group had a greater average hearing gain (13.52 ± 6.99 dB) compared to the endoscopic group (10.03 ± 6.07 dB, P = 0.050). Both groups showed significant postoperative improvements (P < 0.001), with hearing improvement in 90% of the endoscopic group and 96.7% of the microscopic group (P = 0.301).
Conclusion : Although both techniques improved hearing outcomes, the microscopic myringoplasty showed superior gains in air conduction and air-bone gap reduction.