Materials and Methods
This is a comparative study of prospectively obtained data carried out in our center from February 2016 to October 2017. We analyzed the 100 patients who underwent surgery for COM with anterior perforation. The subjects were classified into two groups. The first group comprised of the first fifty cases with anterior perforation underwent microscopic tympanoplasty and assigned as MT. The second group was the next fifty cases who had undergone endoscopic tympanoplasty and was assigned as ET. Out of 100 cases enrolled, 6 patients in MT and 4 patients in ET lost to follow up, thus 44 and 46 patients were included in MT and ET respectively. All the data of the cases used for the study are available.
Inclusion criteria for the study were adult patients, age more than 18 years old, suffering from COM with anterior perforation who required primary type I tympanoplasty with patients having minimum follow up of 12 months. Patients having cholesteatoma, revision cases, retraction pockets, atelectasis, ossicular discontinuity, middle ear discharge, and the perforation involving posterior quadrants were excluded from the study. All cases were done under local anesthesia as a daycare basis. Ethical clearance was obtained from the Institutional Review Board of the (removed for blind peer review). Informed consent was obtained from all the participants of the study.
All surgeries were performed by the first author. Tragal cartilage was used as a graft in the cases that were carried out via a transcanal approach whereas conchal cartilage was used in cases that were done by postaural approach. The shield graft technique using barred cartilage with perichondrium reinforcement technique was used in all cases. Demographic data including age, sex, perforation site, operation time, approach, and graft success rate were evaluated.
For the endoscopic group, all cases were performed transcanally, whereas the microscopic group had approached as permeatal and postaural. Nine cases of the microscopic group needed a postaural approach due to the lack of vision of the anterior margin.