[Quality of life assessment after endoscopic and microscopic myringoplasty using Chinese version of the Zurich chronic middle ear inventory].

Abstract

Objective:To assess and compare therapeutic effects and quality of life after endoscopic and microscopic myringoplasty using Chinese version of the Zurich chronic middle ear inventory（ZCMEI）. Methods:Patients with chronic suppurative otitis media underwent myringoplasty at the Third Hospital of Peking University from October 2018 to September 2019 were included in this study and divided into two groups: endoscopic tympanoplasty group（n=40） and microscopic tympanoplasty group（n=57）. ZCMEI survey and pure tone audiometry were conducted preoperatively and 3-9 months postoperatively. The operation time, intraoperative blood loss, length of hospital, graft success rate, complication rate, hearing improvement and quality of life improvement were compared. Results:①The operation time, length of hospital and intraoperative blood loss of endoscopic group were significantly lower（P<0.05）. ②The graft success rate was 92.5% and 98.2%, respectively（P>0.05）. The difference between the complication rate in two groups was not significant, but patients in endoscopic group had no symptoms of wound numbness or pain. ③Air conduction threshold（AC） and air-bone gap（ABG） were significantly lower after surgery in endoscopic group（n=33） and microscopic group（n=43）. The analyzed result of generalized linear model indicated surgical approach had no influence on postoperative AC and ABG（P>0.05）. ④The total scores of ZCMEI were significantly improved in endoscopic group（n=32） and microscopic group（n=48） postoperatively, as well as the scores of ear symptoms, hearing and psychosocial impact（P<0.05）. Preoperative and postoperative scores of medical resources were not significantly different in either groups（P>0.05）. Controlling the course of disease, the total ZCMEI results and scores of each subscale in patients with single ear involved（n=71） had no significant difference between two groups. Conclusion:Endoscopic myringoplasty has the advantages of minimal invasiveness, short operation time, and quick recovery evaluated from subjective and objective aspects. Audiometry improvement, graft success rate, complication rate and quality of life improvements are comparable between endoscopic tympanoplasty and conventional microscopic tympanoplasty. The assessment of the quality of life is of great significance in efficacy evaluation of otitis media. Doctors should comprehensively consider patient s subjective experience and the objective improvement to obtain the best clinical efficacy.