Modified Push-Through Technique in Bilateral Same-Day Myringoplasty: A Prospective Study.

Abstract

Objective: This study aims to evaluate the efficacy and safety of the modified push-through technique in bilateral same-day myringoplasty for patients with chronic otitis media. Bilateral myringoplasty, while advantageous in terms of cost and recovery time, is often avoided due to the perceived risks, particularly iatrogenic sensorineural hearing loss (SNHL). This study contributes to the limited literature on simultaneous bilateral ear surgeries by assessing surgical outcomes, including graft success rates and postoperative hearing improvement.

Methods: A prospective study was conducted on 50 patients (100 ears) undergoing bilateral same-day myringoplasty at a tertiary care center. The modified push-through technique was employed for all surgeries. Postoperative follow-up was carried out at 1, 3, and 6 months, with evaluations including otomicroscopy and audiometric testing. The primary outcome was graft take rate, and secondary outcomes included air-bone gap (ABG) reduction and incidence of SNHL.

Results: The study demonstrated a graft success rate of 94% across the 100 operated ears. Postoperative audiometry revealed significant improvement in hearing, with the ABG reduced from a preoperative mean of 20 dB to a postoperative mean of 10 dB (p < 0.001). No cases of SNHL were observed.

Conclusion: Bilateral same-day myringoplasty using the modified push-through technique is a viable surgical option for patients with chronic otitis media, offering high graft success rates and significant hearing improvement without increasing the risk of SNHL. This technique could be considered a preferred approach in suitable patients, potentially reducing the need for multiple surgical interventions and associated healthcare costs.