Myringotomy and Ventilation Tube Insertion: Endoscopic versus Microscopic Technique

Abstract

Objectives:

(1) Assess the feasibility of endoscopic-assisted myringotomy and ventilation tube insertion in patients affected by chronic otitis media with effusion (COME). (2) Describe advantages and disadvantages of the endoscopic technique. (3) Compare the outcomes of the endoscopic-assisted approach with those obtained with the traditional microscopic technique.

Methods:

The study was conducted from May 2010 to September 2013 at the ENT University Unit of the A. Fiorini Hospital, Sapienza University of Rome. A total of 24 patients (average age 46 ± 4.5 years; 9 males, 15 females) affected by unilateral or bilateral COME (27 ears, 12 right, 15 left) were enrolled in this prospective controlled trial. The diagnoses were confirmed by otoendoscopic examination, tympanometric and pure-tone audiometric measurements. Patients were randomly divided in 2 groups. Group A patients underwent myringotomy and ventilation tube insertion under endoscopic viewing, whereas in Group B the same procedure was performed using a surgical microscope. All cases were evaluated 1 week after surgery and then monthly until tube extrusion. Complications and tube extrusion times were recorded during follow-up. Audiometric measurements were carried out 2 months after tube extrusion.

Results:

The outcomes of surgery, assessed with endoscopy and audiometric measurements, were similar in the 2 groups. There were no significant differences in mean operative times, tube extrusion times, or complication rates (P > .05).

Conclusions:

The endoscopic technique seems to be a viable alternative to the traditional microscopic approach for myringotomy and ventilation tube positioning in patients affected by COME in the era of endoscopic ear surgery.