Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results.
BACKGROUND
Same-day closure of bilateral tympanic membrane perforations is a quick and more comfortable procedure for the patients. However, conventional bilateral same-day tympanoplasty or myringoplasty has been rarely performed because of the theoretical risk of postoperative complications.


OBJECTIVE
To evaluate the advantages and outcomes of bilateral simultaneous endoscopic cartilage tympanoplasty in patients with bilateral tympanic membrane perforations.


METHODS
From February 2012 to March 2013, patients with bilateral dry tympanic membrane perforations who had some degree of hearing loss corresponding to the size and location of the perforation entered the study. There was no suspicion to disrupted ossicular chain, mastoid involvement or other middle or inner ear pathology. Endoscopic transcanal cartilage tympanoplasty was done using the underlay (medial) technique. The graft was harvested from cymba cartilage in just one ear with preservation of perichondrium in one side. A 1.5cm×1.5cm cartilage seemed to be enough for tympanoplasty in both sides.


RESULTS
Nine patients (4 males and 5 females) with the mean age of 37.9 years underwent bilateral transcanal cartilage tympanoplasty in a same-day surgery. The mean duration of follow up was 15.8 months. There were detected no complications including hearing loss, otorrhea and wound complication with no retraction pocket or displaced graft during follow-up period. The grafts take rate was 94.44% (only one case of unilateral incomplete closure). The mean of air-bone gap overall improved from 13.88dB preoperatively to 9.16dB postoperatively (p<0.05).


CONCLUSIONS
Bilateral endoscopic transcanal cartilage tympanoplasty can be considered as a safe minimally invasive procedure that can be performed in a same-day surgery. It reduces the costs and operation time and is practical with a low rate of postoperative complications.
Iran University of Medical Sciences, Rasoul Akram Hospital, ENT and Head & Neck Surgery Research Center, Tehran, Iran.
Ahmad
A
Daneshi
Iran University of Medical Sciences, Rasoul Akram Hospital, ENT and Head & Neck Surgery Research Center, Tehran, Iran.
Hesam
H
Jahandideh
Iran University of Medical Sciences, Rasoul Akram Hospital, ENT and Head & Neck Surgery Research Center, Tehran, Iran. Electronic address: maham.dr@gmail.com.
Ali
A
Daneshvar
Iran University of Medical Sciences, Rasoul Akram Hospital, ENT and Head & Neck Surgery Research Center, Tehran, Iran.
Mahdi
M
Safdarian
D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000601:surgery*; D014433:Tympanoplasty / Q000379:methods*
Cartilage; Cartilagem; Endoscopia; Endoscopy; Mesmo dia; Perfuração da membrana timpânica; Same-day; Timpanoplastia; Tympanic membrane perforation; Tympanoplasty