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Modified Push-Through Technique in Bilateral Same-Day Myringoplasty: A Prospective Study
Alper Tabaru1, Ozgur Yıgıt, Salih Akyel
1Otolaryngology Department, Basaksehir Cam ve Sakura City Hospital, University of Health Sciences, Istanbul, Turkey.
Objective:
This study aims to evaluate the efficacy and safety of the modified push-through technique in bilateral same-day myringoplasty for patients with chronic otitis media. Bilateral myringoplasty, while advantageous in terms of cost and recovery time, is often avoided due to the perceived risks, particularly iatrogenic sensorineural hearing loss (SNHL). This study contributes to the limited literature on simultaneous bilateral ear surgeries by assessing surgical outcomes, including graft success rates and postoperative hearing improvement.
Methods:
A prospective study was conducted on 50 patients (100 ears) undergoing bilateral same-day myringoplasty at a tertiary care center. The modified push-through technique was employed for all surgeries. Postoperative follow-up was carried out at 1, 3, and 6 months, with evaluations including otomicroscopy and audiometric testing. The primary outcome was graft take rate, and secondary outcomes included air-bone gap (ABG) reduction and incidence of SNHL.
Results:
The study demonstrated a graft success rate of 94% across the 100 operated ears. Postoperative audiometry revealed significant improvement in hearing, with the ABG reduced from a preoperative mean of 20 dB to a postoperative mean of 10 dB ( p < 0.001). No cases of SNHL were observed.
Conclusion:
Bilateral same-day myringoplasty using the modified push-through technique is a viable surgical option for patients with chronic otitis media, offering high graft success rates and significant hearing improvement without increasing the risk of SNHL. This technique could be considered a preferred approach in suitable patients, potentially reducing the need for multiple surgical interventions and associated healthcare costs.
Insights
Bilateral same-day myringoplasty using a modified push-through technique shows high graft success (94%) and improved hearing without sensorineural hearing loss (SNHL). This approach offers a safe and effective option for chronic otitis media patients.
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.
