The postoperative emotional effects of external auditory canal packing following ear surgery: A comparison of endoscopic, endaural, and postauricular approaches in Type I tympanoplasty

This prospective study aimed to investigate the effect of external auditory canal packing for different surgical approaches on short-term postoperative anxiety, depression, and pain in type I tympanoplasty patients. A total of 52 patients (mean age 42.9 ± 14.1 years; 18 male, 34 female) underwent endoscopic (n=15), endaural (n=10), or postauricular (n=27) tympanoplasty between September 2023 and September 2024. Preoperative and postoperative anxiety and depression levels were assessed using the Turkish version of the Hospital Anxiety and Depression Scale. Postoperative pain was measured using the Visual Analog Scale, and associations with psychological parameters were analyzed. The endoscopic group had the lowest mean pain scores (23.3±10.4) and the postauricular group the highest (34.8±19.8), but these differences were not statistically significant (p=0.177). Higher preoperative anxiety scores were moderately associated with greater postoperative pain (p=0.006), and increased postoperative pain correlated with greater increases in depression scores (p=0.027). No significant differences in changes in anxiety or depression scores were found between surgical techniques (p>0.05). In conclusion, surgical approach did not significantly affect short-term anxiety, depression, or pain outcomes, while preoperative anxiety and postoperative pain were more important factors influencing early psychological recovery. Addressing psychological status before surgery may improve postoperative well-being.