{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:26:50Z","timestamp":1784910410733,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T00:00:00Z","timestamp":1531180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004508","name":"Prince of Songkla University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004508","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Although overlay grafting for complicated tympanic perforations offers a high success rate, potential complications may outweigh its advantages. This study aimed to assess endoscopic overlay tympanoplasty (EOT), compared with microscopic overlay tympanoplasty (MOT), to optimize outcomes while minimizing complications associated with large tympanic perforations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Nonmasked, randomized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care university hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Altogether, 70 patients with large tympanic perforations were randomized to undergo overlay tympanoplasty between June 2014 and July 2016. Primary outcome was the visual analog scale (VAS) of pain. Secondary outcomes were anatomic closure, hearing results, middle ear findings, and postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 34 EOT patients and 30\u00a0MOT patients completed the follow\u2010up. VAS scores at 4, 24, and 48 hours in EOT and MOT groups were, respectively, 3 and 8, 1.7 and 6.0, and 0.6 and 4.1. Postoperative pain was less in the EOT group (<jats:italic>P<\/jats:italic> &lt;. 001), and canalplasty was not required (<jats:italic>P<\/jats:italic> =. 003). Graft \u201ctake\u201d rates for EOT and MOT were 97.1% and 93.3%, respectively (<jats:italic>P<\/jats:italic> =. 60). Postoperative air\u2010bone gap was lower with EOT (5.0 vs 10.3\u00a0dB) (<jats:italic>P<\/jats:italic> =. 01). Various middle ear structures were more visible after EOT than after MOT (<jats:italic>P<\/jats:italic> &lt;. 001). Ear protrusion (<jats:italic>P<\/jats:italic> =. 008) and postauricular numbness (<jats:italic>P<\/jats:italic> &lt;. 001) occurred after 50\u00a0MOTs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>EOT for repairing large tympanic perforations provides more favorable anatomical and audiometric outcomes. It also offers superior visibility of middle ear structures without lifting the annulus, with fewer complications and less invasiveness than MOT.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818786948","type":"journal-article","created":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T04:08:36Z","timestamp":1531195716000},"page":"879-886","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Endoscopic vs Microscopic Overlay Tympanoplasty for Correcting Large Tympanic Membrane Perforations: A Randomized Clinical Trial"],"prefix":"10.1002","volume":"159","author":[{"given":"Yuvatiya","family":"Plodpai","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Faculty of Medicine Prince of Songkla University Hatyai Songkhla Province 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