Subgroup analysis
Salzman et al ., set to address the differing uses of endoscopic
and microscopic surgery by dividing operations into reconstructive and
cholesteatoma procedures.5 All mastoid surgery was
excluded. On subgroup analysis, endoscopic cholesteatoma patients
suffered from less pain on post-operative day 1 than the microscopic
group. Where the procedure was reconstructive, there was no significant
difference between groups, but a trend towards less pain within the
endoscopic group than the microscopic group. Unlike this study, we did
not detect a statistically significant difference in pain scores between
our microscopic and endoscopic groups for non-reconstructive procedures,
which included both meatoplasty and cholesteatoma surgery; but found a
statistically significant reduction in VAS after EES compared to
microscopic ear surgery in our reconstructive group at post-operative
days 1 and 2. Numbers within our subgroup analysis were small
(Supplementary Table 1), therefore these results should be approached
with caution. With regards to reconstructive procedures, case series and
metanalysis provide some evidence to support that these may be less
painful than microscopic surgery whilst being conducted
endoscopically.14,15,16