Background & Objective: Tympanoplasty is a widely performed surgical procedure for chronic otitis media (COM), and efforts are being made globally to establish standardized surgical techniques. This study sought to compare the postoperative outcomes of endoscopic and microscopic approaches in COM patients.
Materials & Methods: This randomized clinical trial of an open-label design was performed on 34 patients who were candidates for tympanoplasty surgery due to chronic otitis media in Urmia Imam Khomeini hospital from April to December 2022. Patient allocation was performed by grouping participants according to odd or even numbers, with half assigned to the endoscopic group and the remaining half assigned to the microscopic group.  Demographic data, pain severity, operation duration, and graft success rate preoperatively and 3 and 6 months postopera­tively were evaluated. Independent samples t-test, Chi-square test, and SPSS version 21were used to analyze data. A P-value ˂0.05 was considered statistically significant.
Results: No significant difference was reported in terms of pre and postoperative pure tone audiometry conditions between the two groups. Significantly lower operation time (65.83 ± 11.6 minutes) was reported in the endoscopic group compared to the microscopic group (P=0.001). The graft success rate in the microscopic and endoscopic groups was 77.8% and 75%, respectively, which was not statistically significantly different (P = 0.84). A significant difference was observed between microscopic and endoscopic groups in the pain score of patients immediately after surgery (5.66 ±18.1 and 3.75 ± 1, retrospectively) and one day after surgery (5.50 ± 1.9  and 3.62 ± 0.95, respectively) (P < 0.001).
Conclusion: Endoscopic tympanoplasty technique has demonstrated comparable efficacy in improving hearing loss as the conventional method. However, its advantages in terms of reduced operating time and postoperative pain suggest that it may emerge as the preferred approach for tympanoplasty surgery.