Single Sitting Bilateral Myringoplasty: Outcomes and Complications

Abstract

Abstract Background Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations. Traditionally each ear drum is taken up for grafting sequentially in two different sittings. The reluctance to deal with both sides at the same sitting has been primarily due to a theoretical risk of iatrogenic sensory-neural hearing loss, need of bilateral ear canal gauze packing and chances of graft intake failure. Chronic Suppurative Otitis Media (CSOM) is a widely prevalent public health problem presenting with discomfort, hearing loss, otorrhea and psychological trauma. CSOM is characterized by an inflammatory process of the middle ear often associated with irreversible tissue alterations. It may be further classified into safe chronic otitis media and unsafe chronic otitis media according to the absence or presence of a cholesteatoma. Aim This study aim at assessing the single stage bilateral surgical procedure in bilateral tympanic membrane perforation caused by chronic otitis media as regard the graft take and hearing improvement as outcomes. Methodology A meta-analysis study is done to assess the feasibility and the possibility of operating the bilateral perforation in tympanic membrane in chronic otitis media cases on same session rather than doing it in separate sessions. The outcomes that were selected to evaluate such approach are graft take and hearing improvement. Hospital stay, cost of the operation and time were supposed to be evaluated however, there was no sufficient data to treat such outcomes in this meta analytic study upon that these outcomes are going to be appraised and stated bases on the available data. Results The graft take was evaluated on the bases paper by ototscopic examination post operative from 3 weeks to 3 months by closure of the perforation. It was estimated in this study to be 88%. This percent is matching the result obtained by Ihsan et al 2016 “who operated on 50 patients with a graft uptake rate of 86 %”, Olusesi et al, 2017 " with a total of 38 participants underwent either bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential different-day tympanoplasty (20 patients, 40 ears). The overall graft take rate was 88 per cent (32 out of 36 ears in the same-day tympanoplasty group, 35 out of 40 ears in the different-day tympanoplasty group; p = 0.96, odds ratio = 0.984)" (88 %), and Katsura et al, 2005 who revised the SUM using a 17 patients who underwent bilateral same-day surgery with a success rate of (85%). Conclusion Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation with a high success rate as regard the graft take and hearing improvement.