Comparative Study of Endoscopic and Microscopic Type I Tympanoplasty in Terms of Delayed Facial Palsy

Author:

Li Kuan-Hui1,Chan Leong-Perng23,Chen Chin-Kuo45,Kuo Shin-Huei6,Wang Ling-Feng12,Chang Ning-Chia27,Wang Hsun-Mo1,Ho Kuen-Yao12,Chien Chen-Yu12

Affiliation:

1. Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

2. Department of Otorhinolaryngology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

3. Department of Otorhinolaryngology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan

4. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan

5. Communication Enhancement Center, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

6. Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

7. Department of Otorhinolaryngology, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung, Taiwan

Abstract

Objective Delayed facial palsy is a complication of otologic surgery. Tympanoplasty is commonly employed in chronic otitis media. We compared the incidence and characteristics of delayed facial palsy and hearing restoration between endoscopic and microscopic tympanoplasty for the treatment of simple chronic otitis media. Study Design Retrospective cohort study. Setting Tertiary medical center. Subjects and Methods We retrospectively analyzed 468 patients who underwent type I tympanoplasty from January 2009 to April 2017. Patients were divided into transcanal endoscopic ear surgery and microscopic ear surgery groups. Their epidemiological profiles were reviewed and the outcomes of tympanoplasty were analyzed. Blood sample tests for herpes simplex virus and varicella-zoster virus immunoglobulin M and immunoglobulin G were arranged in patients with delayed facial palsy. Results Transcanal endoscopic ear surgery exhibited similar benefits to microscopic ear surgery in graft-taking rate and hearing restoration but had a shorter operation time ( P < .01). Eight patients (1.71%) developed delayed facial palsy, but no statistically significant difference was observed between the 2 surgical approaches. All patients tested negative for varicella-zoster virus and herpes simplex virus immunoglobulin M and positive for immunoglobulin G of the same viruses; however, the titer did not exhibit a 4-fold increase, implying that patients did not have active viral infections. Conclusion Transcanal endoscopic ear surgery is an ideal alternative for simple tympanoplasty. The incidence of delayed facial palsy was not significantly different between the 2 approaches. Because of the favorable prognosis and the absence of direct serological evidence supporting viral reactivation, treatment with antivirals may not be required.

Funder

ministry of science and technology, taiwan

kaohsiung medical university chung-ho memorial hospital

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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