Results of 1065 operations (604 myringoplasties‡ and 461 tympanoplasties §) performed by a single surgeon using either underlay homograft dura, underlay autograft temporalis fascia or overlay autograft temporalis fascia are compared.Pre-operative and operative conditions are analysed to determine which of these influence results.

Second-ear hearing results are poorer in those who require a drill-out of this ear, and this is more likely to be required if a drill-out was required in the first ear, regardless of a successful outcome of the first procedure. Patients should be aware of the reduced likelihood of success in these cases and be counseled regarding risks and benefits of second-ear surgery based, in part, on the findings from the first ear. This study confirms that bilateral advanced footplate obliteration and overhanging or dehiscent facial nerves may be anticipated in patients found to have these abnormalities during first-ear stapedectomy.

No abstract