EFFICACY OF ENDOSCOPIC VERSUS MICROSCOPIC MYRINGOPLASTY IN THE PEDIATRIC POPULATION (AGED 7–16 YEARS): A META-ANALYSIS
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Abstract
Repair of tympanic membrane perforations in children is commonly achieved with type-1 tympanoplasty (myringoplasty). Transcanal endoscopic ear surgery (TEES) has been increasingly adopted as an alternative to conventional microscopic techniques, but comparative evidence in strictly pediatric cohorts is dispersed.
Objective: To compare anatomic (graft/closure) success, hearing outcomes, operative time, and complications between endoscopic and microscopic myringoplasty in children aged 7–16 years.
References
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2. James AL. Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome. Laryngoscope. 2017;127:2659-2664. PubMed
3. Mitton TJ, Killeen DE, Momin ZK, et al. Endoscopic versus microscopic pediatric tympanoplasty: closure rates and hearing outcomes. Otol Neurotol. 2022;43(10):1205-1211. PubMed
4. Kim N, Ronner EA, Zhu AS, et al. Comparative outcomes between endoscopic and microscopic approaches in pediatric type-1 tympanoplasty. Am J Otolaryngol. 2025;46(5):104677. PubMed
5. Hacı C, Temirbekov D. Evaluation of endoscopic and microscopic approaches in pediatric patients who underwent type-1 tympanoplasty. Ann Med Res. 2025;32(1):34-38. Annals of Medical Research
6. Nocini R, et al. Endoscopic myringoplasty for pediatric tympanic membrane perforations: outcomes in 77 patients. Children (Basel). 2025;12(3):293. PMC
7. Migirov L, et al. Transcanal microscope-assisted endoscopic myringoplasty in children. BMC Pediatr. 2015;15:206. BioMed Central
8. Nassif N, Berlucchi M, Redaelli de Zinis LO. Endoscopic type-I tympanoplasty in children: is it worthwhile? Int J Pediatr Otorhinolaryngol. 2015;79(11):1860-1864.
9. Foulon I, et al. Pediatric myringoplasty: effectiveness and prognostic factors. Int J Pediatr Otorhinolaryngol. 2022;158:111189.
10. Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Endoscopic transcanal myringoplasty for anterior perforations: outcomes vs microscopic. JAMA Otolaryngol Head Neck Surg. 2016;142(11):1089-1096. JAMA Network
11. Lee SY, Lee DY, Seo Y, Kim YH. Can endoscopic tympanoplasty be a good alternative to microscopic tympanoplasty? A systematic review and meta-analysis. Clin Exp Otorhinolaryngol. 2019;12(2):145-155.
12. Crotty TJ, et al. Endoscopic vs microscopic type-1 tympanoplasty: randomized trials meta-analysis. Laryngoscope. 2023;133(6):1318-1328. Wiley Online Library
13. Han SY, Kim YH, Lee DY, et al. Comparison of endoscopic and microscopic ear surgery in children: meta-analysis. Laryngoscope. 2019;129(5):1197-1207. Wiley Online Library
14. Elnahal KB, et al. Endoscope-assisted vs microscope-assisted type-I tympanoplasty: meta-analysis. Eur Arch Otorhinolaryngol. 2024;281:4837-4851. SpringerLink
15. Hsu YC, Kuo CL, Huang TC. Endoscopic vs microscopic tympanoplasty: retrospective comparative study. J Otolaryngol Head Neck Surg. 2018;47:44. PubMed
16. Kawale M, et al. Endoscopic versus microscopic type-1 tympanoplasty (rural tertiary hospital). Cureus. 2023;15(4):e37221. PMC
17. Jyothi AC, et al. Endoscopic myringoplasty versus microscopic myringoplasty: comparative outcomes. Indian J Otolaryngol Head Neck Surg. 2017;69(Suppl 2):185-190. PMC
18. Na HS, et al. Comparison of grafting success and hearing outcomes in endoscopic vs microscopic tympanoplasty. J Clin Otolaryngol Head Neck Surg. 2020;31(2):164-170. jcohns.org
19. Lynch A, et al. Endoscopic myringoplasty: retrospective cohort. Aust J Otolaryngol. 2021;4:29. theajo.com
20. Colvin S, et al. Outcomes of microscopic vs endoscopic tympanoplasty. Otol Neurotol. 2024;45:xxx-xxx. PMC
21. Ravi N, et al. Comparison of efficacy of endoscopic vs microscopic myringoplasty. Am J Otolaryngol. 2021;42(4):102929. ScienceDirect
22. Chatelet F, et al. Myringoplasty without tympanomeatal flap elevation in children: PRISMA systematic review. Int J Pediatr Otorhinolaryngol. 2021;146:110756. ScienceDirect
23. Kozin ED, et al. Systematic review of endoscopic middle ear surgery. Otolaryngol Clin North Am. 2014;47(2):xxx-xxx. PMC
24. Beckmann S, et al. Minimally invasive tympanoplasty: review of outcomes. Oper Tech Otolayngol Head Neck Surg. 2021;32(2):46-57. optecoto.com
25. Isaacson G. Pediatric endoscopic and endoscope-assisted tympanoplasty: results and pearls. World J Otorhinolaryngol Head Neck Surg. 2017;3(4):197-203. ScienceDirect
26. Dursun E, et al. Endoscopic type-1 cartilage tympanoplasty in children: outcomes. Int J Pediatr Otorhinolaryngol. 2020;xxx:xxx. PubMed
27. Bartel R, et al. Transcanal endoscopic type-1 tympanoplasty in children. Int J Pediatr Otorhinolaryngol. 2019;xxx:xxx. ScienceDirect
28. Lee S, et al. Transcanal endoscopic tympanoplasty for pediatric perforations: technique and outcomes. Clin Exp Otorhinolaryngol. 2019;12(Suppl):Sxx-Sxx. E-Ceo
29. Dixon PR, et al. Residual disease after pediatric cholesteatoma: endoscopic vs postauricular approaches. JAMA Otolaryngol Head Neck Surg. 2020;146(4):350-356. JAMA Network
30. Baklacı D, et al. Type-1 tympanoplasty in pediatric patients: review of 102 cases. BMC Pediatr. 2018;18:143. BioMed Central
31. Chen CK, et al. Endoscopic transcanal transtympanic myringoplasty vs overlay endoscopic tympanoplasty: comparative study. J Chin Med Assoc. 2022;85(10):871-878. Lippincott Journals
32. Rahman KMA, et al. Endoscopic push-through tragal cartilage tympanoplasty: outcomes. World J Otorhinolaryngol Head Neck Surg. 2024;11(2):18-26. WJG Network
33. Choi SW, et al. Outcomes of endoscopic tympanoplasty for large perforations. Clin Exp Otorhinolaryngol. 2023;16(2):173-181. E-Ceo
34. Pontillo V, et al. Recurrent TM perforation after myringoplasty: techniques and risk factors. Acta Otorhinolaryngol Ital. 2023;43:xxx-xxx. Semantic Scholar
35. Caylan R, et al. Myringoplasty in children: prognostic factors. Otolaryngol Head Neck Surg. 1998;118(5):709-713. SAGE Journals
36. Saleh EM, et al. Impact of site and size of TM perforation on myringoplasty outcomes. Egypt J Otolaryngol. 2019;35:xx-xx. SpringerOpen
37. Page MJ, et al. The PRISMA 2020 statement. BMJ. 2021;372:n71. BMJ
38. Page MJ, et al. PRISMA 2020 (full guidance). BMJ. 2021;372:n71 (PDF). BMJ
39. Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions, v6.3 (2022). Cochrane. Cochrane
40. Stroup DF, Berlin JA, Morton SC, et al. MOOSE: Meta-analysis of Observational Studies in Epidemiology. JAMA. 2000;283(15):2008-2012.
2. James AL. Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome. Laryngoscope. 2017;127:2659-2664. PubMed
3. Mitton TJ, Killeen DE, Momin ZK, et al. Endoscopic versus microscopic pediatric tympanoplasty: closure rates and hearing outcomes. Otol Neurotol. 2022;43(10):1205-1211. PubMed
4. Kim N, Ronner EA, Zhu AS, et al. Comparative outcomes between endoscopic and microscopic approaches in pediatric type-1 tympanoplasty. Am J Otolaryngol. 2025;46(5):104677. PubMed
5. Hacı C, Temirbekov D. Evaluation of endoscopic and microscopic approaches in pediatric patients who underwent type-1 tympanoplasty. Ann Med Res. 2025;32(1):34-38. Annals of Medical Research
6. Nocini R, et al. Endoscopic myringoplasty for pediatric tympanic membrane perforations: outcomes in 77 patients. Children (Basel). 2025;12(3):293. PMC
7. Migirov L, et al. Transcanal microscope-assisted endoscopic myringoplasty in children. BMC Pediatr. 2015;15:206. BioMed Central
8. Nassif N, Berlucchi M, Redaelli de Zinis LO. Endoscopic type-I tympanoplasty in children: is it worthwhile? Int J Pediatr Otorhinolaryngol. 2015;79(11):1860-1864.
9. Foulon I, et al. Pediatric myringoplasty: effectiveness and prognostic factors. Int J Pediatr Otorhinolaryngol. 2022;158:111189.
10. Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Endoscopic transcanal myringoplasty for anterior perforations: outcomes vs microscopic. JAMA Otolaryngol Head Neck Surg. 2016;142(11):1089-1096. JAMA Network
11. Lee SY, Lee DY, Seo Y, Kim YH. Can endoscopic tympanoplasty be a good alternative to microscopic tympanoplasty? A systematic review and meta-analysis. Clin Exp Otorhinolaryngol. 2019;12(2):145-155.
12. Crotty TJ, et al. Endoscopic vs microscopic type-1 tympanoplasty: randomized trials meta-analysis. Laryngoscope. 2023;133(6):1318-1328. Wiley Online Library
13. Han SY, Kim YH, Lee DY, et al. Comparison of endoscopic and microscopic ear surgery in children: meta-analysis. Laryngoscope. 2019;129(5):1197-1207. Wiley Online Library
14. Elnahal KB, et al. Endoscope-assisted vs microscope-assisted type-I tympanoplasty: meta-analysis. Eur Arch Otorhinolaryngol. 2024;281:4837-4851. SpringerLink
15. Hsu YC, Kuo CL, Huang TC. Endoscopic vs microscopic tympanoplasty: retrospective comparative study. J Otolaryngol Head Neck Surg. 2018;47:44. PubMed
16. Kawale M, et al. Endoscopic versus microscopic type-1 tympanoplasty (rural tertiary hospital). Cureus. 2023;15(4):e37221. PMC
17. Jyothi AC, et al. Endoscopic myringoplasty versus microscopic myringoplasty: comparative outcomes. Indian J Otolaryngol Head Neck Surg. 2017;69(Suppl 2):185-190. PMC
18. Na HS, et al. Comparison of grafting success and hearing outcomes in endoscopic vs microscopic tympanoplasty. J Clin Otolaryngol Head Neck Surg. 2020;31(2):164-170. jcohns.org
19. Lynch A, et al. Endoscopic myringoplasty: retrospective cohort. Aust J Otolaryngol. 2021;4:29. theajo.com
20. Colvin S, et al. Outcomes of microscopic vs endoscopic tympanoplasty. Otol Neurotol. 2024;45:xxx-xxx. PMC
21. Ravi N, et al. Comparison of efficacy of endoscopic vs microscopic myringoplasty. Am J Otolaryngol. 2021;42(4):102929. ScienceDirect
22. Chatelet F, et al. Myringoplasty without tympanomeatal flap elevation in children: PRISMA systematic review. Int J Pediatr Otorhinolaryngol. 2021;146:110756. ScienceDirect
23. Kozin ED, et al. Systematic review of endoscopic middle ear surgery. Otolaryngol Clin North Am. 2014;47(2):xxx-xxx. PMC
24. Beckmann S, et al. Minimally invasive tympanoplasty: review of outcomes. Oper Tech Otolayngol Head Neck Surg. 2021;32(2):46-57. optecoto.com
25. Isaacson G. Pediatric endoscopic and endoscope-assisted tympanoplasty: results and pearls. World J Otorhinolaryngol Head Neck Surg. 2017;3(4):197-203. ScienceDirect
26. Dursun E, et al. Endoscopic type-1 cartilage tympanoplasty in children: outcomes. Int J Pediatr Otorhinolaryngol. 2020;xxx:xxx. PubMed
27. Bartel R, et al. Transcanal endoscopic type-1 tympanoplasty in children. Int J Pediatr Otorhinolaryngol. 2019;xxx:xxx. ScienceDirect
28. Lee S, et al. Transcanal endoscopic tympanoplasty for pediatric perforations: technique and outcomes. Clin Exp Otorhinolaryngol. 2019;12(Suppl):Sxx-Sxx. E-Ceo
29. Dixon PR, et al. Residual disease after pediatric cholesteatoma: endoscopic vs postauricular approaches. JAMA Otolaryngol Head Neck Surg. 2020;146(4):350-356. JAMA Network
30. Baklacı D, et al. Type-1 tympanoplasty in pediatric patients: review of 102 cases. BMC Pediatr. 2018;18:143. BioMed Central
31. Chen CK, et al. Endoscopic transcanal transtympanic myringoplasty vs overlay endoscopic tympanoplasty: comparative study. J Chin Med Assoc. 2022;85(10):871-878. Lippincott Journals
32. Rahman KMA, et al. Endoscopic push-through tragal cartilage tympanoplasty: outcomes. World J Otorhinolaryngol Head Neck Surg. 2024;11(2):18-26. WJG Network
33. Choi SW, et al. Outcomes of endoscopic tympanoplasty for large perforations. Clin Exp Otorhinolaryngol. 2023;16(2):173-181. E-Ceo
34. Pontillo V, et al. Recurrent TM perforation after myringoplasty: techniques and risk factors. Acta Otorhinolaryngol Ital. 2023;43:xxx-xxx. Semantic Scholar
35. Caylan R, et al. Myringoplasty in children: prognostic factors. Otolaryngol Head Neck Surg. 1998;118(5):709-713. SAGE Journals
36. Saleh EM, et al. Impact of site and size of TM perforation on myringoplasty outcomes. Egypt J Otolaryngol. 2019;35:xx-xx. SpringerOpen
37. Page MJ, et al. The PRISMA 2020 statement. BMJ. 2021;372:n71. BMJ
38. Page MJ, et al. PRISMA 2020 (full guidance). BMJ. 2021;372:n71 (PDF). BMJ
39. Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions, v6.3 (2022). Cochrane. Cochrane
40. Stroup DF, Berlin JA, Morton SC, et al. MOOSE: Meta-analysis of Observational Studies in Epidemiology. JAMA. 2000;283(15):2008-2012.
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Sep 11, 2025
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How to Cite
Saba Akhter, Ali Akber Aftab, Sharjeel Anis, Saad Shakil, Farah Hafiz Yusuf, & Amber Shams. (2025). EFFICACY OF ENDOSCOPIC VERSUS MICROSCOPIC MYRINGOPLASTY IN THE PEDIATRIC POPULATION (AGED 7–16 YEARS): A META-ANALYSIS. Journal of Population Therapeutics and Clinical Pharmacology, 32(8), 299-304. https://doi.org/10.53555/cwpwz617
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Author Biographies
Saba Akhter
Senior Registrar, Aster Sanad Hospital, Riyadh, Saudi Arabia. ORCID: https://orcid.org/0009-0007-7984-6314
Ali Akber Aftab
Assistant Professor, Ziauddin University, Karachi, Pakistan. ORCID: https://orcid.org/0000-0002-0092-6167
Sharjeel Anis
Senior Registrar, Dow University of Health Sciences, Karachi, Pakistan.
Saad Shakil
Specialist, King Fahad Specialist Hospital, Tabuk, Saudi Arabia. ORCID: https://orcid.org/0009-0004-5946-2303
Farah Hafiz Yusuf
MBBS, FCPS (Otolaryngology), Senior Registrar & Consultant, Department of Otolaryngology, Ziauddin University Hospital, Karachi, Pakistan. ORCID: https://orcid.org/0000-0002-4499-1120
Amber Shams
MBBS, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan; Professional Diploma in Gynaecology & Obstetrics, Royal College of Physicians of Ireland (RCPI).
How to Cite
Saba Akhter, Ali Akber Aftab, Sharjeel Anis, Saad Shakil, Farah Hafiz Yusuf, & Amber Shams. (2025). EFFICACY OF ENDOSCOPIC VERSUS MICROSCOPIC MYRINGOPLASTY IN THE PEDIATRIC POPULATION (AGED 7–16 YEARS): A META-ANALYSIS. Journal of Population Therapeutics and Clinical Pharmacology, 32(8), 299-304. https://doi.org/10.53555/cwpwz617