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A comparative study of sequential vs. simultaneous type I tympanoplasty in patients with bilateral chronic otitis
Preethi Umamaheswaran1, Sanjeev Mohanty2, Vinoth Manimaran3
1Department of ENT, Head & Neck Surgery, Panimalar Medical College Hospital & Research Institute, Chennai, Tamil Nadu, India.
Background:
Patients with bilateral chronic otitis media - mucosal type have been conventionally treated with sequential tympanoplasty. Bilateral simultaneous tympanoplasty is usually not preferred because of the theoretical risk of iatrogenic sensorineural hearing loss. With the advent of modern surgical instruments and surgical techniques, the risk is expected to be lower. This study compares the clinical outcomes in type I tympanoplasty performed simultaneously and sequentially.
Materials & Methods:
This randomized prospective study was carried out in a tertiary care hospital between August 2015 and July 2017. A total of 30 patients were divided into two groups of 15 each. This study analyzed the graft uptake, pure tone audiogram findings pre- and post-operatively, duration of surgery and number of hospital visit for each patient and the outcomes were compared between both the groups.
Result:
Patients undergoing bilateral simultaneous tympanoplasty had significantly lesser mean duration of surgery and number of hospital visits than the patients undergoing sequential tympanoplasty. Graft uptake and postoperative wound infections were similar in both the groups. Postoperative hearing improvement was significantly better in the bilateral simultaneous tympanoplasty group. However, further studies are needed to authenticate this observation. None of the patients had a postoperative deterioration of hearing or sensorineural hearing loss.
Conclusion:
Bilateral simultaneous tympanoplasty is not only feasible but also better than sequential tympanoplasty, especially in terms of operating time, follow-up and overall financial implications on the patient.
