Comparison of bilateral same-day and sequential endoscopic cartilage myringoplasty for bilateral chronic tympanic membrane perforation

Abstract

Background: There is debate over the applicability of bilateral same-day myringoplasty in patients with bilateral chronic tympanic membrane perforations (TMPs) requiring ear surgery on both sides.

Objectives: To evaluate the healing and hearing outcomes of bilateral endoscopic ‘push-through’ cartilage myringoplasty in patients with bilateral chronic TMPs with mucosal chronic otitis media (COM) on the same day.

Material and methods: The medical records of 60 patients (120 ears) with bilateral chronic TMPs who underwent bilateral same-day or sequential endoscopic push-through cartilage myringoplasty between January 2014 and March 2019 were evaluated.

Results: Of the 60 patients with 120 ears, 26 patients with 52 ears were in the bilateral same-day group and 34 patients with 68 ears in the sequential group. The overall graft success rate at 3 months was 92.3% (48/52) in the same-day group and 94.1% (64/68) in the sequential group. None of the sensorineural HL and retraction pockets occurred in two groups.

Conclusions and significance: Bilateral push-through cartilage myringoplasty can be performed safely for the patients with bilateral chronic TMPs in the same day, it significantly reduced the medical costs and shortened the operation time and length of stay compared to sequential myringoplasty.

Chinese abstract

背景：对于需要耳外科手术的双侧慢性鼓膜穿孔（TMPs）患者, 双侧同日鼓膜成形术的适用性存在着争议。

目的：评价对双侧慢性TMPs伴黏膜性慢性中耳炎（COM）患者行双侧内窥镜下“推穿式”软骨鼓膜成形术的疗效和听力结果。

材料与方法：对2014年1月至2019年3月间60例（120耳）双侧慢性鼓膜穿孔患者行双侧同天或连续内镜下鼓膜成形术的病历资料进行分析。

结果：在120只耳的60例患者中, 双侧同日组26例52只耳, 序贯组34例68只耳。术后3个月移植成功率：同日组为92.3%（48/52）, 序贯组为94.1%（64/68）。两组均无感觉神经性HL及回缩囊发生。

结论及意义：双侧慢性鼓膜穿孔患者可在同一天内安全进行双侧推穿软骨鼓膜成形术。与连续鼓膜成形术相比, 这种可显著降低医疗费用, 并缩短手术时间和住院时间。

Keywords:

• Endoscope
• tympanic membrane perforation
• cartilage graft
• myringoplasty
• bilateral same-day surgery
• success rate

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the Science and Technology Agency of Yiwu city, China [Grants#2018-3-76].