Outcomes After Exoscopic Versus Microscopic Type 1 Tympanoplasty.

Autor:	Fan CJ; Michigan Ear Institute, Farmington Hills, Michigan., Fritz CG; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania., Lucas JC; Michigan Ear Institute, Farmington Hills, Michigan., Conway RM; Michigan Ear Institute, Farmington Hills, Michigan., Kato MG; Michigan Ear Institute, Farmington Hills, Michigan., Babu SC; Michigan Ear Institute, Farmington Hills, Michigan.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2024 Jul 01; Vol. 45 (6), pp. 671-675.
DOI:	10.1097/MAO.0000000000004220
Abstrakt:	Objective: To analyze the outcomes of exoscopic versus microscopic type 1 tympanoplasty. Study Design: Retrospective chart review. Setting: Tertiary care otology-neurotology practice. Patients: Adult subjects with a diagnosis of tympanic membrane perforation from 2018 to 2022. Intervention: Exoscopic or microscopic tympanoplasty with cartilage + perichondrium or perichondrium/fascia graft. Main Outcome Measures: Primary outcomes were graft success rate (1 wk, 3 wk, 3 mo, and 6 mo postoperatively) and operative time. Secondary outcomes included audiometric outcomes of postoperative air-bone gap (ABG), change in ABG, pure tone average (PTA), speech reception threshold (SRT), and word recognition score (WRS) at 6-month follow-up and complication rates of cerebrospinal fluid leak, facial nerve injury, persistent tinnitus, and persistent vertigo. Results: Seventy-one patients underwent type 1 tympanoplasty by a single surgeon. Thirty-six patients underwent exoscopic tympanoplasty, and 35 patients underwent microscopic tympanoplasty. Cartilage and perichondrium were utilized in 27 subjects (75.0%) in the exoscopic group and in 25 subjects (71.4%) in the microscopic group (p = 0.7, Cramer's V = 0.04). Graft success rate was as follows (exoscope versus microscope): 100% (36/36) versus 100% (35/35) at 1 week (p = 1.0, Cramer's V = 0.0), 97.2% (35/36) versus 100% (35/35) at 3 weeks (p = 1.0, Cramer's V = 0.1), 97.2% (35/36) versus 94.3% (33/35) at 3 months (p = 1.0, Cramer's V = 0.07), and 91.7% (33/36) versus 91.4% (32/35) at 6 months (p = 0.7, Cramer's V = 0.0). Operative time was 57.7 minutes for the exoscopic group and 65.4 minutes for the microscopic group (p = 0.08, 95% CI [-16.4, 0.9], Cohen's d = 0.4). There were no serious complications. All preoperative and postoperative audiometric outcomes were comparable. Conclusions: The outcomes after exoscopic versus microscopic type 1 tympanoplasty are comparable. Competing Interests: Funding and Conflicts of Interest: No sources of funding or conflicts of interest to report. (Copyright © 2024, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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