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Bilateral myringoplasty in chronic otitis media
Per Caye-Thomasen1, Torfinnur Rubek Nielsen, Mirko Tos
1Departments of Oto-Rhino-Laryngology, Head and Neck Surgery, Gentofte University Hospital of Copenhagen, Hellerup, Denmark. peca@gentoftehosp.kbhamt.dk
The Laryngoscope
|May 3, 2007
Summary
Bilateral myringoplasty is a safe and effective procedure for chronic otitis media, achieving high closure rates and significant hearing improvement without iatrogenic hearing loss. Patients reported satisfaction with the outcomes.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Audiology
Background:
- Some otosurgeons hesitate to perform bilateral myringoplasty/tympanoplasty type I due to theoretical risks of iatrogenic sensorineural hearing loss.
- This study addresses this concern by presenting outcomes of bilateral surgical procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of simultaneous bilateral myringoplasty/tympanoplasty type I in patients with chronic otitis media.
- To assess the incidence of iatrogenic sensorineural hearing loss and the functional hearing outcomes.
Main Methods:
- Prospective study of 26 patients (52 ears) with bilateral dry tympanic membrane perforations.
- Transcanal approach with onlay technique using fascia, tragal perichondrium, or cartilage palisades.
- Follow-up included pure tone and speech audiometry at a mean of 13.8 months.
Main Results:
- Successful perforation closure in 94% of ears.
- Significant improvement in hearing and reduction of air-bone gap (closed to within 10 dB in 92%).
- No cases of iatrogenic sensorineural hearing loss were observed.
Conclusions:
- Bilateral myringoplasty is a safe procedure with good functional outcomes.
- The surgery is cost-effective and leads to patient satisfaction.
- Temporary hearing impairment from ear canal packing is modest and acceptable.
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