الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Background : Intraoperative evaluation of middle ear anatomy during endoscopic surgery for inflammatory disorders allows the visualization of anatomic blockages of the middle ear ventilation patterns. Many other investigators have described the anatomy and development of tympanic compartments and folds because this knowledge is crucial in the understanding and treatment of middle ear disease Aim of this study: To compare two surgical designs for better visualization of ventilation routes of the middle ear and importance of patency of these routes for the success of the surgery. Methods : It is a retrospective randomize study underwent on 24 patients admitted to ORL Department of Mansoura University Hospital and Hearing and Speech Institute after fulfilling inclusion and exclusion criteria during the study period (Jan 1st, 2019 – August 30th, 2021). Results : There are no significant differences between the two groups regarding age, sex, BMI, smoking, nasal pathology, diabetes mellitus, side (Right & Left), pre and postoperative air-bone gab. There is a significant decrease in air-bone gab postoperatively in both groups. There is no significant difference found between the groups for preoperative air–bone gaps and postoperative air–bone gaps (< 10, 1020, and > 20 dB). Regarding group A, 2 patients (16%) were <10 dB preoperatively that turn into 9 (75%) patients postoperatively, 6 patients (50%) were 10-20dB that turn into 2 (17%) patients postoperatively and 4 patients (34%) were > 20dB that turn into one (8%) patient postoperatively. There is a highly significant difference found postoperatively. Regarding group B, 3 patients (25%) were <10 dB preoperatively that turn into 10 (84%) patients postoperatively, 5 patients (41%) were 1020dB that turn into 1 (8%) patients postoperatively and 4 patients (34%) were > 20dB that turn into one (8%) patient postoperatively. There is a significant difference found postoperatively. There was one case of polypoidal mucosa at anterior isthmus and one case of polypoidal mucosa at eustachian tube opening in group B without statistical significance difference. Operative time was significantly lower in group A compared to group B. The success rate was lower in group A compared to group B but without statistically significant difference. Conclusion: Endoscopic tympanoplasty type I is a reliable technique with anatomic and audiologic results : comparable to endoscopic transcanal transperforation myringoplasty grafted by cartilage (butterfly technique) with no statistical significant difference between both techniques.