Modified Push-Through Technique in Bilateral Same-Day Myringoplasty: A Prospective Study

Area of Science:

• Otolaryngology
• Surgical Innovation
• Audiology

Background:

• Bilateral myringoplasty offers efficiency but carries perceived risks, including sensorineural hearing loss (SNHL).
• Limited data exists on simultaneous bilateral ear surgeries, necessitating evaluation of novel techniques.
• Chronic otitis media management often requires surgical intervention to improve hearing and prevent complications.

Purpose of the Study:

• To assess the efficacy and safety of the modified push-through technique for bilateral same-day myringoplasty.
• To evaluate graft success rates and hearing outcomes in patients with chronic otitis media.
• To determine the incidence of iatrogenic sensorineural hearing loss (SNHL) following the procedure.

Main Methods:

• Prospective study of 50 patients (100 ears) undergoing bilateral same-day myringoplasty.
• Utilized the modified push-through technique for all surgical procedures.
• Conducted 1, 3, and 6-month follow-ups with otomicroscopy and audiometric testing to assess graft take, air-bone gap (ABG) reduction, and SNHL.

Main Results:

• Achieved a high graft success rate of 94% across 100 ears.
• Demonstrated significant hearing improvement, reducing the air-bone gap (ABG) from a mean of 20 dB to 10 dB (p < 0.001).
• Observed no instances of sensorineural hearing loss (SNHL).

Conclusions:

• Bilateral same-day myringoplasty with the modified push-through technique is a safe and effective surgical option.
• The technique provides high graft success and significant hearing gain without increased SNHL risk.
• This approach may reduce healthcare costs and the need for multiple surgeries in suitable chronic otitis media patients.