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Background and Objectives : The purpose of this study was to compare the surgical outcomes of endoscopic tympanoplasty with those of the microscopic retro-aural approach. Materials and Methods : Data of patients who underwent tympanoplasty type I, performed by a single surgeon, at the Pusan National University Hospital between April 2011 and June 2019 were investigated retrospectively. The outcomes were analyzed in terms of the graft success rate, operating time, hospital stay duration, hearing gain with pure tone audiometry (PTA), and preoperative and postoperative air-bone gap (ABG). Results : Of the 388 ears, 199 (51%) underwent endoscopic tympanoplasty (ET), and 189 (49%) underwent microscopic tympanoplasty (MT) with a retro-aural approach. ET resulted in a graft success rate of 92.5%, whereas MT led to a graft success rate of 96.3% (p=0.158). The mean gain of ABG was 5.79±8.93 in the ET group and 6.90±8.11 in the MT group, respectively (p=0.423). The median surgical time was 54 min in the ET group and 94 min in the MT group. The operation time was shorter in the ET group than in the MT group (p<0.001). Further, the hospitalization period was also shorter in the ET group (3 days) than in the MT group (7 days) (p<0.001). Conclusions : ET is an alternative to MT as it has a comparable graft success rate and improved hearing. In addition, ET is cosmetic owing to no incision, with a shorter operation and hospital stay duration.
