A prospective comparative study between endoscopic and microscopic myringotomy with ventilation tube insertion

Abstract Background Otitis media with effusion (OME) is a common ear disorder and a major cause of hearing loss in children. When conservative management fails, myringotomy with ventilation tube (VT) insertion remains the gold standard surgical treatment. Aim of the work to evaluate the intraoperative and postoperative outcomes of the endoscopic and microscopic myringotomy with VT insertion in patients with persistent OME. Methods This prospective randomized comparative study was performed on 56 patients diagnosed with persistent OME for more than three months. Patients were randomly divided into two equal groups: Group A underwent microscopic myringotomy with VT insertion, while Group B underwent endoscopic myringotomy with VT insertion. Outcomes assessed included operative time, intraoperative bleeding, external auditory canal or tympanic membrane injuries, postoperative pain, infection, otorrhea, and early tube extrusion. Results The two groups did not differ significantly regarding intraoperative injuries, intraoperative bleeding, postoperative pain, otorrhea, or early tube extrusion. However, operative time was significantly shorter in the endoscopic group than in the microscopic group ( P < 0.001), and postoperative infection rates were significantly lower in the endoscopic group ( P = 0.04). A positive correlation was observed between operative time and intraoperative bleeding. Conclusions Endoscopic myringotomy with VT insertion is a safe and efficient alternative to the conventional microscopic approach.