INTRODUCTION
Tympanoplasty is a surgical procedure aiming at eradication of
infection, repair of the perforated tympanic membrane (TM), and hearing
rehabilitation in patients with chronic otitis media
(COM).1 Middle ear infections, trauma or iatrogenic
injury are the principal causes of the TM perforation. Up to 80% of TM
perforations heal spontaneously;2 as for the
remaining, surgical repair is usually required.3
With the endoscope assistance, minimally invasive techniques of ear
surgery have arisen and evolved since the 1990s.4Analogous to functional endoscopic sinus surgery, so too did the concept
of functional endoscopic ear surgery (FEES). The philosophy of FEES
fundamentally supports three essential principles: 1. using the external
auditory canal (EAC) as the natural conduit to the tympanic cavity;
2. restoring normal ventilation routes of the middle ear and the
mastoid; and 3. conserving as much normal anatomy as
possible.5 Consequently, endoscopic ear surgery has
become widely accepted with anatomical and physiological
concepts.6
Despite the well-known merits of endoscopic techniques, some concerns
about their efficiency and safety are still exist among some ear
surgeons and hinder the transition from conventional microscopic
tympanoplasty to endoscopic tympanoplasty for those
surgeons.7
Therefore, there is a need for a meta-analysis comparing the outcomes of
both endoscopy and microscopy techniques of type I tympanoplasty in
terms of efficacy and safety.