Tympanomastoidectomy: Microscopic or Endoscopic

Introduction Microscopic surgery is the gold standard for surgeries of the middle ear, mastoid, and lateral skull base. Microscopic ear surgery is performed at a very high level, with very good results with respect to control of pathologies and hearing function. Although endoscopic ear surgery is still in its infancy, it is gaining increasing attention internationally. The first reason for this increasing interest is the patients’ wish for minimal invasive surgery to avoid an external incision.

Aim To study whether endoscopic ear surgery is safer and less invasive than conventional tympanomastoid surgery using an operating microscope.

Materials and Methods There are 100 patients who underwent endoscopic ear surgery and another 100 patients in whom microscopic tympanomastoidectomy was performed by the same surgeon. The two surgical techniques were compared with respect to disease clearance from middle ear and mastoid, the time taken for operation, postoperative hearing results, postoperative complications, and postoperative pain.

Results Here, no differences in operating time or postoperative graft take up and hearing between the endoscopic and microscopic groups were observed. There was very little postoperative pain in the endoscopic group. In endoscope group, disease clearance was difficult when mastoid tip was involved. In microscopic group, disease clearance was difficult when sinus tympani was involved.

Conclusion In tympanomastoidectomy, microscope and endoscope compliment to each other. With combined use of microscope and endoscope, we can attain good results in tympanomastoidectomy with minimal morbidity.