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Simultaneous bilateral myringoplasty as a single-stage operation




Myringoplasty is a common otologic procedure that results in successful closure of the perforation in most cases; however, the theoretical risk of iatrogenic sensorineural hearing loss during surgery has induced a reluctance among otosurgeons to perform bilateral myringoplasty.


The aim of this study was to evaluate simultaneous bilateral myringoplasty as a single-stage operation.

Patients and methods

A prospective study was carried out between December 2009 and March 2012 on 30 patients (60 ears) with bilateral tympanic membrane perforations. Bilateral myringoplasty was performed in the same sitting using an underlay technique.


Of the 60 ears operated upon, perforation closure was achieved in 56 (93.3%) ears and 51 (80%) ears gained hearing. No worsening of hearing was observed in any ear.


Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation, with a high success rate.


  1. Sitnikov V, Zavarzin B, Chernushevich I, Kuzovkov V. Modern concepts in myringoplasty. Balkan Journal of Otology & Neuro-Otology. 2004; 4: 93–95.

    Google Scholar 

  2. Tarasov DI. Disease of the middle ear. M Medicine. 1988; 66: 1076–1095.

    Google Scholar 

  3. Kumar N, Madkikar NN, Kishve S, Chilke D, Shinde KJ. Using middle ear risk index and et function as parameters for predicting the outcome of tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2012; 64: 13–16.

    Article  Google Scholar 

  4. Rourke T, Snelling JD, Aldren C. Cartilage graft butterfly myringoplasty: how we do it. Clin Otolaryngol. 2010; 35: 135–138.

    Article  CAS  Google Scholar 

  5. Al-Khtoum N, Hiari MA. Myringoplasty in children: retrospective analysis of 35 cases. Braz J Otorhinolaryngol. 2009; 75: 371–374.

    PubMed  Google Scholar 

  6. Yu MS, Yoon TH. Bilateral same-day surgery for bilateral perforated chronic otitis media: inlay butterfly cartilage myringoplasty. Otolaryngol Head Neck Surg. 2010; 143: 669–672.

    Article  Google Scholar 

  7. Caye-Thomasen P, Nielsen TR, Tos M. Bilateral myringoplasty in chronic otitis media. Laryngoscope. 2007; 117: 903–906.

    Article  Google Scholar 

  8. Karkanevatos A, De S, Srinivasan VR, Roland NJ, Lesser THJ. Day-case myringoplasty: five years’ experience. J Laryngol Otol. 2003; 117: 763–765.

    Article  CAS  Google Scholar 

  9. Saliba I, Woods O. Hyaluronic acid fat graft myringoplasty: a minimally invasive technique. Laryngoscope. 2011; 121: 375–380.

    Article  Google Scholar 

  10. Iranfar K, Iranfar S. Does surgery of chronic otitis media cause sensori neural hearing loss? Pak J Med Sci. 2009; 25: 972–975.

    Google Scholar 

  11. Maharjan M, Kafle P, Bista M, Shrestha S, Toran KC. Observation of hearing loss in patients with chronic suppurative otitis media tubotympanic type. Kathmandu Univ Med J. 2009; 7: 397–401.

    Article  CAS  Google Scholar 

  12. Salisu AD. Otology practice in a Nigerian tertiary health institution: a 10-year review. Ann Afr Med. 2010; 9: 218–221.

    Article  CAS  Google Scholar 

  13. Voss SE, Rosowski JJ, Merchant SN, Peake WT. Non-ossicular signal transmission in human middle ears: experimental assessment of the ‘acoustic route’ with perforated tympanic membranes. J Acoust Soc Am. 2007; 122: 2135–2153.

    Article  Google Scholar 

  14. Olowookere SA, Ibekwe TS, Adeosun AA. Pattern of tympanic membrane perforation in Ibadan: a prospective study. Ann Ibadan Postgrad Med. 2008; 6: 843–853.

    Google Scholar 

  15. Abdel-Hamid O, Khatib OMN, Aly A, Morad M, Kamel S. Prevalence and patterns of hearing impairment in Egypt: a national household survey. East Mediterr Health J. 2007; 13: 1170–1180.

    Article  CAS  Google Scholar 

  16. Omran AA. Endoscopic bivalve inlay cartilage myringoplasty for central perforations: preliminary report. Egypt J Ear Nose Throat Allied Sci. 2012; 13: 37–42.

    Article  Google Scholar 

  17. Shrestha S, Sinha BK. Hearing results after myringoplasty. Kathmandu Univ Med J. 2006; 4: 455–459.

    CAS  Google Scholar 

  18. Gersdorff M, Garin P, Decat M, Juantegui M. Myringoplasty: long-term results in adults and children. Am J Otol. 1995; 16: 532–535.

    CAS  PubMed  Google Scholar 

  19. Karela M, Berry S, Watkins A, Phillipps JJ. Myringoplasty: surgical outcomes and hearing improvement: is it worth performing to improve hearing? Eur Arch Otrhinolaryngol. 2008; 265: 1039–1042.

    Article  CAS  Google Scholar 

  20. Dornhoffer JL. Hearing results with cartilage tympanoplasty. Laryngoscope. 1997; 107: 1094–1099.

    Article  CAS  Google Scholar 

  21. Yung M, Neumann C, Vowler SL. A longitudinal study on pediatric myringoplasty. Otol Neurotol. 2007; 28: 353–355.

    Article  Google Scholar 

  22. Caylan R, Titiz A, Falcioni M, De Donato G, Russo A, Taibah A, Sanna M. Myringoplasty in children: factors influencing surgical outcome. Otolaryngol Head Neck Surg. 1998; 118: 709–713.

    CAS  PubMed  Google Scholar 

  23. Palva T, Karja J, Palva A. High tone sensorineural losses following chronic ear surgery. Arch Otolaryngol. 1973; 98: 176–178.

    Article  CAS  Google Scholar 

  24. Cruz OLM, Costa SS, Kluwe LH, Smith MM. Timpanoplastias. In: Cruz OLM, Costa SS, editors. Otologia Clínica e Cirúrgica. Rio de Janeiro: Revinter; 2000. pp. 245–270.

    Google Scholar 

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Correspondence to Mohammad W. El-Anwar.

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El-Ahl, M.A.S., Amer, H.S. & El-Anwar, M.W. Simultaneous bilateral myringoplasty as a single-stage operation. Egypt J Otolaryngol 29, 16–19 (2013).

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