ORIGINAL RESEARCH article
Front. Surg.
Sec. Pediatric Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1649552
Endoscopic versus Microscopic Tympanoplasty in Children: A Retrospective Case-Control Study
Provisionally accepted
Raffael Fink1*
Sven Beckmann1
Sean Christopher Sheppard1,2
Marco Domenico Caversaccio1,3
Lukas Anschuetz4,5- 1Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- 2Université Paris Cité, Institut Pasteur, AP-HP, Inserm, CNRS, Fondation Pour l’Audition, Institut de l’Audition, IHU reConnect, Technologies et thérapie génique pour la surdité, Paris, France
- 3Universitat Bern, Bern, Switzerland
- 4Department of Otorhinolaryngology, Head and Neck Surgery, CHUV, University of Lausanne, Lausanne, Switzerland
- 5The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
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Purpose: To compare the outcomes of endoscopic and microscopic tympanoplasty (TPL) types I-III in pediatric patients. Methods: A retrospective case-control study was conducted on 70 TPL cases in 58 pediatric patients at Inselspital, Bern University Hospital, Switzerland, from June 2017 to December 2023. Data on hearing function, graft intake, residual disease, operating time and complications were collected. Results: We observed mean postoperative air-bone gap (ABG) of 16.83 dB using the endoscopic and 19.37 dB for the microscopic techniques, as well as a higher graft intake rate (91%) for the endoscopic compared to the microscopic group (80%), although these differences did not reach statistical significance. No residual cholesteatoma was found in the endoscopic group, while the microscopic group had a significantly higher incidence of residual disease (42%; p = .03). The mean operative time was shorter in the endoscopic group (87 minutes vs. 113 minutes; p < .01). Postoperative complications were lower in the endoscopic group compared to a 14% incidence in the microscopic group. Conclusion: Endoscopic tympanoplasty in pediatric patients achieves similar audiological outcomes and graft intake rates compared to the microscopic approach while offering significant advantages, including reduced operation times and lower complication rates. This minimally invasive approach is highly effective especially regarding cholesteatoma resection and provides excellent functional and structural outcomes.
Keywords: Endoscopic ear surgery, Microscopic ear surgery, pediatric, Cholesteatoma, Tympanoplasty, Hearing Loss
Received: 26 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Fink, Beckmann, Sheppard, Caversaccio and Anschuetz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Raffael Fink, Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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