This randomised, controlled study compares the tympanoplasty outcomes in two groups of patients: one undergoing bilateral tympanoplasty on the same day (18 patients, 36 ears) and the other having the same procedure done on different days, with a gap of at least three months (20 patients, 40 ears). In both groups, there was a predominance of subtotal perforations. Conchal and tragal cartilage was used. There is no mention of associated mastoid disease or major ossicular defects. The patients were operated under general anaesthesia. There was no significant difference in terms of hospital stay (three days), graft take rate, graft infection and postoperative hearing improvement in the comparisons made collectively for all perforation sizes in the two groups. However, there was a significant difference between the length of surgery, that in the staged group being much longer.

Bilateral tympanoplasty on the same day saved about US$600. It remains debatable if both ears should be operated on the same day or whether bilateral surgery should be staged months apart.

However, the risks of SNHL, damage to the inner ear and the facial nerve can be put in the right perspective for straightforward tympanoplasty operations using cartilage grafts, such as those mentioned here. This is particularly relevant when considering costs and difficulties in access to specialist care in developing countries.

Outcome and cost analysis of bilateral sequential same-day cartilage tympanoplasty compared with bilateral staged tympanoplasty.
Olusesi AD, Oyeniran.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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