Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Long Term Versus Short Term Hearing Results in Endoscopic Sandwich Myringoplasty

Document Type : Original

Authors
Bikash Lal Shrestha
Ashish Dhakal
Aakash Pradhan
Monika Pokharel
Pradeep Rajbhandari
Abha Kiran KC
Krishna Sundar Shrestha
Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
10.22038/ijorl.2021.54372.2857
Abstract
Introduction:
The use of the endoscope in otological surgeries has both diagnostic and therapeutic values. It provides an excellent view in difficult nooks and corners. The use of endoscopic sandwich myringoplasty using cartilage and perichondrium has its benefit in hearing outcome and graft uptake in long-term follow-up. The main objective was to compare the long-term with short- term hearing outcomes in those who have undergone endoscopic sandwich myringoplasty with Dhulikhel hospital (D‑HOS) technique.
Materials and Methods:
Forty-two patients who underwent endoscopic sandwich myringoplasty with D-HOS technique using tragal cartilage perichondrium were enrolled in the study. The hearing outcome was analyzed by comparing the pre-operative findings  with post-operative findings and amongst post-operative patients, long-term with short-term  air bone gap (ABG) and ABG closure in speech frequencies (0.5kHz, 1kHz, 2kHz, 4kHz) were compared.
Results:
Amongst forty-two patients, 40 (95.2%) had graft uptake in both short-term (6.08 months) and in long-term (20 months) follow-up. The mean pre-operative ABG was 28.1±9.3dB whereas the mean short-term post-operative ABG was 14.5±7.2dB, it showed statistical significance (P=0.001). Likewise, while comparing pre-operative with long-term post-operative ABG (13.4±4.8 dB), it showed statistical significance of P=0.000. While comparing short-term with long-term post-operative ABG, it did not show any statistical significance (P=0.065).The mean closure in ABG in both short-term and long-term hearing assessment was not statistically significant (P=0.077).
Conclusion:
Endoscopic sandwich myringoplasty with D-HOS technique is a reliable procedure with good hearing outcome and graft uptake in both short and long-term follow-up.
Keywords
Air bone gap
Endoscopy
Myringoplasty
Perichondrium
Tragal cartilage graft
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Iranian Journal of Otorhinolaryngology
Volume 33, Issue 5
September and October 2021
Pages 291-299