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Late-Breaking Scientific Oral Presentations

Otology/Neurotology

Session: Late-Breaking Scientific Orals: Otology and Neurotology

Endoscopic Versus Microscopic Tympanoplasty: A Single-Blinded Randomized Control Trial

Sunday, September 29, 2024
3:18 PM – 3:24 PM EDT
Location: MBCC, 222
Disclosure(s):
Aparna Govindan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Enrique R. Perez, MD, MBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Maura KELLY Cosetti, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Endoscopic ear surgery has gained popularity as an alternative to microscopic techniques, but there is limited prospective evidence comparing audiometric and patient-reported outcomes. This trial investigates whether any differences exist between endoscopic and microscopic tympanoplasty techniques.

Methods: This single-blinded prospective trial was performed between 2022-2024 at a tertiary otology clinic. Participants were over 18 years old undergoing tympanoplasty for dry tympanic membrane perforation (without cholesteatoma). Enrolled subjects were preoperatively randomized to microscopy or endoscopy. The primary outcome was air-bone gap change at 6 months postoperatively. Secondary measures include other audiometric outcomes including speech recognition thresholds (SRT) and word recognition scores (WRS). Patient-reported outcome measures (PROMs) such as visual analog scale (VAS), Return to Work Self-Efficacy (RTWSE-19), and Glasgow Benefit Index (GBI) were collected at intervals 6 months postoperatively. Student’s t-tests and chi square were used. Intention to treat, per protocol, and as treated analyses were conducted.

Results: In total, 38 adults (ages 21-83, mean 42.4) were enrolled. 16 received microscopy, 15 received endoscopy, 2 were randomized to endoscopy but converted to microscopy, and 1 was randomized to microscopy but converted to endoscopy. Additionally, 4 participants were lost to follow-up without 6-month postoperative audiograms and were therefore excluded from analysis. Due to high participant dropout rates in PROM surveys after 3 weeks, only PROMs collected within 3 weeks postoperatively were analyzed. In all analyses, the primary outcome did not significantly differ (p = 0.93, 0.87, 0.83) and there were no significant differences (p > 0.05) between demographics, secondary audiometric outcomes, or PROMs.

Conclusions: Our findings suggest that endoscopic approaches to tympanoplasty have no difference in postoperative audiometric outcomes or PROMs when compared to traditional microscopic approaches.

    Presenting Author(s)

  • AG

    Aparna Govindan, MD

    Fellow
    University of Miami/Jackson Memorial Health
    Miami, FL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • MS

    Mia M. Saade, BS

    Medical Student
    Icahn School of Medicine at Mount Sinai
    New York, New York, United States

    Disclosure information not submitted.

  • Jennifer Ren, BA

    Medical Student
    Icahn School of Medicine At Mount Sinai
    New York, New York, United States

    Disclosure information not submitted.

  • Zachary Schwam, MD

    Assistant Professor
    Mount Sinai Health System
    new york, NY, United States

    Disclosure information not submitted.

  • EP

    Enrique R. Perez, MD, MBA

    Assistant Professor
    New York Eye and Ear Infirmary of Mount Sinai
    New York, NY, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Maura Cosetti, MD

    Associate Professor, Director, Ear Institute of New York Eye and Ear Infirmary of Mount Sinai
    Ear Institute of New York Eye and Ear Infirmary of Mount Sinai
    New York, New York, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • George B. Wanna, MD

    Professor
    Mount Sinai Health System
    New York, NY, United States

    Disclosure information not submitted.