Endoscopic versus microscopic ossiculoplasty in chronic otitis media: a systematic review of the literature

Objective: The aim of this study was to compare the endoscopic and microscopic ossiculoplasty in patients with chronic otitis media. Methods: MEDLINE, ScienceDirect, and the Cochrane Library databases as well as other sources were searched by two independent reviewers. Controlled studies comparing endoscopic and microscopic ossiculoplasty in patients with chronic otitis media were included. Mean air–bone gap closure was the primary outcome. Secondary outcomes were operation time and complications. Results: Three studies met the inclusion criteria. No statistically significant differences in audiometric outcomes between endoscopic and microscopic groups in all three included studies were reported. Although endoscopic technique was related to a fewer number of postoperative complications and a shorter operation time, these outcomes did not reach statistical significance. Conclusion: Endoscopic ossiculoplasty is associated with similar postoperative hearing results compared to the traditional microscopic approach. A trend towards a shorter operative time and reduced morbidity for the endoscopic approach has been observed, but well-designed randomized controlled trials are warranted to confirm this finding.