Bilateral same-day endoscopic tympanoplasty: a paradigm shift? or mere hype?

Area of Science:

• Otolaryngology
• Minimally Invasive Surgery
• Global Health

Background:

• Middle ear disease and tympanic membrane perforations are common globally.
• Access to timely and effective surgical interventions like tympanoplasty can be limited in developing countries.
• Endoscopic techniques offer potential advantages in minimally invasive ear surgery.

Purpose of the Study:

• To evaluate the feasibility of performing simultaneous bilateral same-day endoscopic tympanoplasty.
• To assess the safety and efficacy of this procedure in a secondary-level hospital setting.
• To determine the resource-saving potential of this surgical approach.

Main Methods:

• A prospective interventional cohort study was conducted in North India.
• Twenty patients (40 ears) with bilateral large central/subtotal perforations aged 10-50 years underwent the procedure.
• Temporalis fascia grafts were harvested for endoscopic trans-canal underlay tympanoplasty on both ears in a single session.

Main Results:

• Successful graft uptake was achieved in 38 out of 40 ears (95%) at 6 months post-operation.
• Significant improvement in hearing was observed, with average air-bone gap closure of 14.5 dB (p < 0.001).
• No postoperative sensorineural hearing loss or complications were reported.

Conclusions:

• Simultaneous bilateral same-day endoscopic tympanoplasty is a feasible, safe, and efficient surgical option.
• The procedure demonstrates high graft success rates and significant hearing improvement.
• This approach conserves valuable time and resources for patients and healthcare providers.