Bilateral Endoscopic Type 1 Tympanoplasty in a Single Session: Functional and Clinical Outcomes

Abstract

Objective: This study aims to evaluate the functional and clinical outcomes of single-session bilateral endoscopic type 1 tympanoplasty, with a focus on postoperative (post-op) hearing improvement and graft success rates in patients with chronic otitis media and tympanic membrane perforations.

Methods: Fifteen patients (30 ears) with bilateral dry tympanic membrane perforations underwent trans-canal endoscopic type 1 tympanoplasty using a tragal perichondrium graft. Preoperative (pre-op) and post-op audiometric data, including pure-tone averages (PTAs) and air-bone gap (ABG) measurements at various frequencies, were collected and analyzed.

Results: Functional success was defined as a post-op ABG <20 dB and PTA level improvements, while clinical success was determined by the presence of an intact tympanic membrane graft. The mean pre-op ABG significantly decreased post-oply in both ears, with an average ABG improvement of 25.00±7.32 dB at 500 Hz in the right ear and 18.00±8.41 dB in the left ear. The post-op PTA demonstrated an average gain of 27.00±7.51 dB in the right ear and 29.33±6.23 dB in the left ear. The functional success rate, defined as a post-op ABG <20 dB, was 93.33%, while clinical success, based on graft integrity, was also 93.33%.

Conclusion: Single-session bilateral endoscopic tympanoplasty is a safe and effective procedure with high functional and clinical success rates. It leads to significant hearing improvement and has minimal post-op complications.

Keywords: Tympanoplasty; chronic otitis media; endoscopic surgery; hearing improvement; perichondrium; surgical outcomes.