Abstract
OBJECTIVE: To compare closure rates of endoscopic and microscopic tympanoplasty (MT) as influenced by perforation size, perforation location, and graft position. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary university medical center. PATIENTS: Adult patients who underwent tympanoplasty by a fellowship-trained neurotologist from January 2010 to December 2019, had at least 2 months of follow-up, and had a tympanic perforation with no cholesteatoma before surgery. INTERVENTIONS: Transcanal endoscopic tympanoplasty (ET) or MT. MAIN OUTCOME MEASURES: The primary outcome is postoperative closure of the tympanic membrane perforation as assessed using otomicroscopy at the last follow-up appointment. RESULTS: Two-hundred and eleven patients-98 in the transcanal ET group and 113 in the MT group-were identified. Tympanic membrane closure rates were not significantly different between the ET and MT groups (79.6% and 84.1% respectively; P = 0.473), and further multivariable analysis revealed that closure rates for ET relative to MT had an insignificant odds ratio (0.56; P = 0.144). Similar analyses also found no significant difference between the 2 methods in subsets of perforation size (small, large, subtotal/total), perforation location (anterior, posterior, inferior), and graft position (underlay, overlay). CONCLUSIONS: ET resulted in similar rates of postoperative closure rates compared with the microscopic technique.