Microscopic versus endoscopic myringotomy with/without grommet insertion

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Egyptian Journal of Ear, Nose, Throat and Allied Sciences


Aim: Otitis Media with Effusion (OME) in children requires myringotomy, which is usually done under microscope. Use of endoscope in ear surgeries has increased. So we compared outcome of myringotomy under microscope and endoscope. Patients and Methods: Time bound descriptive non-randomized study was done in a tertiary care hospital on 3-13 year’s old children with OME, with ‘B’ type tympanogram. Myringotomy ± grommet insertion was done either under microscope or endoscope. Primary outcome observed was time taken for various steps of procedure. Additional observations like narrow canal, overhang and injury of ear canal; visualization of entire tympanic membrane (TM), satisfactory clarity of view and depth perception were noted. Results: Out of 33 patients, 18 and 13 underwent procedure under microscope and endoscope respectively. Time for myringotomy on right side under microscope was 80.73 seconds, under endoscope was 30.63 seconds (P < 0.001); on left side under microscope was 59.08 seconds, under endoscope was 35.41 seconds (P < 0.001). Time between procedure on one ear and contralateral ear was 151.53 seconds under microscope and 60.23 seconds under endoscope (P < 0.001). Endoscopic grommet insertion took longer than microscopic technique on right ear (P=0.037). Under endoscope, ability to visualize entire TM, satisfactory clarity of view and depth perception were statistically significant (P < 0.001). Conclusion: Less operative time, satisfactory depth perception, clarity of field and visualizing of entire TM make myringotomy ± grommet insertion with endoscope a better alternative than microscopic procedure.

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