The Outcomes of Overlay Myringoplasty: Endoscopic Versus Microscopic Approach

Purpose: To investigate the outcomes of overlay myringoplasty by comparing the endoscopic versus the microscopic approach.

Materials And Methods: This is a retrospective comparative study of 181 patients who underwent myringoplasty with overlay techniques between January 2010 and 2016 at Songklanagarind Hospital, Thailand. Group 1 underwent an endoscopic-assisted (n=90), and group 2 underwent the microscopic-assisted (n=91) overlay myringoplasty. The outcomes were graft take rates, the audiometric results, the need of canalplasty, complications and operative time. All patients were followed up for at least 6months.

Results: The graft take rates were 96.7% in the endoscopic group and 91.2% in the microscopic group, p=0.22. The operative time was 98.9±11.0min for the endoscopic group, and 176.6±14.9min for the microscope group, p<0.001. There was no need for intraoperative canalplasty in the endoscopic group; however, 4% of cases in the microscopic group required canalplasty, p=0.12. The postoperative air-bone gap (ABG) closure was not different between both groups, p=0.09. Postoperative complications including post auricular numbness (p<0.001), aural fullness (p=0.002), and ear protrusion (p=0.005) were found in the microscopic group more than the endoscopic group.

Conclusions: Endoscopic overlay myringoplasty provided satisfactory surgical as well as audiometric outcomes when compared with the microscopic approach. The graft take rate and postoperative hearing were similar in both groups. The endoscopic approach seemed to be superior than the microscopic approach in term of operative time, complication, and no need for canalplasty.