Publication:

Simultaneous bilateral tympanoplasty with or without mastoidectomy

Background Bilateral simultaneous tympanoplasty with or without mastoidectomy scores over traditional sequential unilateral tympanoplasty with or without mastoidectomy in terms of convenience and cost-effectiveness for the patients with conservation of resources. But it is rarely performed, mainly because of the theoretical risk of iatrogenic sensorineural deafness. The outcomes of bilateral single-stage tympanoplasty with or without mastoidectomy studied are sparse in the literature. Authors intend to evaluate the risks of these procedures in the current era of advanced instrumentation and newer techniques, where the risk of complications is expected to be minimal in experienced hands, and to evaluate our results regarding hearing gain, graft uptake, and complications.

Methods A total of 23 patients with bilateral central perforation of the tympanic membrane who underwent surgery of both ears simultaneously were retrospectively analysed (January 2017 to November 2023). The results were evaluated regarding graft uptake, hearing gain, and complications like sensorineural hearing loss (SNHL), facial nerve palsy, and chorda tympani nerve damage.

Results Closure of perforation was successful in 89.1% of patients, and hearing improvement was observed in 95.7%. None of the patients had iatrogenic sensorineural hearing loss or facial nerve palsy. One patient had inadvertent bilateral chorda tympani nerve damage.

Conclusions Simultaneous bilateral tympanoplasty/tympanomastoidectomy is a convenient, cost-effective procedure for patients with bilateral disease. The risk of SNHL is negligible if cases are chosen appropriately, and it has a similar success rate as a single-stage procedure.