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

Objective: To ascertain the feasibility of simultaneous bilateral same-day endoscopic tympanoplasty in a secondary-level hospital in a developing country.

Material & methods: A prospective interventional cohort study conducted at a secondary-care hospital in North India.

Inclusion criteria: Consenting patients having bilateral perforations aged 10-50 years.

Exclusion criteria: Cholesteatoma/granulations/need for ossiculoplasty/previously operated ear/s. Temporalis fascia graft sufficient to repair 2 perforations was harvested from a right-side supratemporal incision followed by endoscopic trans-canal underlay tympanoplasty on both ears in the same session.

Follow-up: 7th day and 1, 3, and 6 months post-operatively. An intact graft at 6 months was considered surgical success. Hearing improvement was assessed by pure tone audiometry done 6 months postoperatively.

Results: 20 patients (40 ears) had large central/subtotal perforations. 38 out of 40 ears had successful graft uptake at 6 months. Average preoperative and postoperative air-bone gaps were 31+-4.4, 16.6+-2.9 dB respectively (p < 0.001, significant). Average air-bone gap closure was14.5+-3.2 dB. There was no instance of postoperative sensorineural hearing loss/postoperative complications.

Conclusion: Bilateral same-day endoscopic tympanoplasty is feasible, safe, and efficient, saving time and resources for both the healthcare system and patients.