A comparative study of sequential vs. simultaneous type I tympanoplasty in patients with bilateral chronic otitis media - Mucosal type.

Autor:	Umamaheswaran P; Department of ENT, Head & Neck Surgery, Panimalar Medical College Hospital & Research Institute, Chennai, Tamil Nadu, India., Mohanty S; Department of ENT, Head & Neck Surgery, MGM Healthcare, Chennai, Tamil Nadu, India., Manimaran V; Department of ENT, Head & Neck Surgery, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India., Jayagandhi S; Department of ENT, Head & Neck Surgery, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India., Jeyabalakrishnan SP; Department of ENT, Head & Neck Surgery, Karpagam Faculty of Medical Sciences & Research, Coimbatore, Tamil Nadu, India.
Jazyk:	angličtina
Zdroj:	Journal of otology [J Otol] 2020 Jun; Vol. 15 (2), pp. 59-61. Date of Electronic Publication: 2020 Jan 03.
DOI:	10.1016/j.joto.2019.12.005
Abstrakt:	Background: Patients with bilateral chronic otitis media - mucosal type have been conventionally treated with sequential tympanoplasty. Bilateral simultaneous tympanoplasty is usually not preferred because of the theoretical risk of iatrogenic sensorineural hearing loss. With the advent of modern surgical instruments and surgical techniques, the risk is expected to be lower. This study compares the clinical outcomes in type I tympanoplasty performed simultaneously and sequentially. Materials & Methods: This randomized prospective study was carried out in a tertiary care hospital between August 2015 and July 2017. A total of 30 patients were divided into two groups of 15 each. This study analyzed the graft uptake, pure tone audiogram findings pre- and post-operatively, duration of surgery and number of hospital visit for each patient and the outcomes were compared between both the groups. Result: Patients undergoing bilateral simultaneous tympanoplasty had significantly lesser mean duration of surgery and number of hospital visits than the patients undergoing sequential tympanoplasty. Graft uptake and postoperative wound infections were similar in both the groups. Postoperative hearing improvement was significantly better in the bilateral simultaneous tympanoplasty group. However, further studies are needed to authenticate this observation. None of the patients had a postoperative deterioration of hearing or sensorineural hearing loss. Conclusion: Bilateral simultaneous tympanoplasty is not only feasible but also better than sequential tympanoplasty, especially in terms of operating time, follow-up and overall financial implications on the patient. Competing Interests: There is no conflict of interest among the authors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. (© 2019 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd.)
Databáze:	MEDLINE
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