الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
chronic suppurative otitis media is a major health problem worldwide with higher incidence among the developing countries that affect the quality of life and daily activities, it also carries the burden of recurrent ear infections and possibility of long standing complications. The mucosal type of CSOM is one of its common types. In CSOM inactive mucosal type, the size of tympanic membrane perforation is considered the backbone in choosing the best method for the repair of TM and not to expose the patient to risk of failure with need to revision surgery. The subtotal and total perforations are challenging and need further care in surgery especially in the way of placing the graft material. Several methods and techniques were used as overlay, underlay, over underlay and interlay. Each of the mentioned techniques has its own advantages and disadvantages. Dealing with cases of CSOM subtotal and total types by the otologists require obvious intra-operative handling especially during placing the grafting material. The aim of our study is comparing between outcomes of endoscopic transcanal and microscopic postauricular type I tympanoplasty using underlay technique with complete circumferential flap as regards to graft uptake and hearing improvement. The use of this technique is to get the least possible complication in cases of subtotal and total perforations of CSOM inactive mucosal type. We performed our study on 60 patients classified into two groups 30 patients with microscope (group A) and 30 patients with endoscope (group B), we reported 93.4% graft uptake in group A and 96.7% graft uptake in group B. We reported 35.0 ± 8.0 dB hearing improvement mean in group A and 25.0 ± 7.5 dB hearing improvement mean in group B. Also we reported 1 case of retraction in group A and 2 cases of retraction in group B. Finally we reported 2 cases with residual perforations in group A and 1 case with residual perforation in group B. We reported significant improvement in both techniques regarding graft uptake and hearing results. No significant differences were found by comparing the endoscope with the microscope. By analysis of our results, the graft uptake and hearing improvement were compatible with studies as Varghese and Narayanan in 2019 and Mishra in 2007, but higher than other studies as Rathi in 2018 and Pradhan in 2015 who used the same technique of circumferential flap. Our results regarding graft uptake and hearing improvement were higher than other studies as Prakash in 2018 who used postauricular underlay tympanoplasty with anterior tucking of graft and Furukawa in 2014 who used endoscopic transcanal mringoplasty.