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

Kuan Hui Li, Leong Perng Chan, Chin Kuo Chen, Shin Huei Kuo, Ling Feng Wang, Ning Chia Chang, Hsun Mo Wang, Kuen Yao Ho, Chen Yu Chien*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations

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.

Original languageEnglish
Pages (from-to)645-651
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume164
Issue number3
DOIs
StatePublished - 03 2021

Bibliographical note

Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2020.

Keywords

  • delayed facial palsy
  • herpes simplex virus
  • microscopic ear surgery
  • transcanal endoscopic ear surgery
  • tympanoplasty
  • varicella-zoster virus

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