ARCIMS 26
in
Sunday 2025-10-19 19:44
Does Nitrous Oxide Affect Underlay Tympanoplasty Outcomes? A Case-Control Study
Mohammad Saleh Shafiei 1 ℗, Ali Shahzeidi 2 ©, Mohammad Mandegari 2, Vida Ayatollahi 3, Mohammadhossein Baradaranfar 2, Mojtaba Meybodian 2, Sedighe Vaziribozorg 2, Mohamad Reza Jalili 1, Asma Khosravi Najafabadi 1, Ali Zolfaghari 1
Abstract
Title: Does Nitrous Oxide Affect Underlay Tympanoplasty Outcomes? A Case-Control Study Introduction: Tympanoplasty is a standard procedure for repairing tympanic membrane perforations and restoring hearing. While N₂O is a usual gas introduced by anesthetists, there have always been concerns that it might raise pressure in the middle ear and thereby interfere with graft success. This study was undertaken to investigate whether the use of N₂O during surgery really has any influence on the outcome. Methods and Materials: In this case-control study, 30 adult patients scheduled for underlay tympanoplasty were enrolled and randomly split into two groups of 15. One group received N₂O during graft placement; the other did not. All surgeries were carried out by the same surgeon using a consistent method. People with conditions like cholesteatoma, diabetes, smoking habits, or a history of previous ear surgery were not included. Follow-up was then carried out postoperatively at 1, 2, and 4 months, with microscopic investigation of graft integrity. Perforation at the 4-month follow-up was termed graft failure. Statistical analysis was done with SPSS version 28 with significance at P 0.05. Results: The patients included 18 women and 12 men. On average, those in the N₂O group were older (around 47 years) than those in the control group (about 38 years). Graft success was seen in 80% of the N₂O group and 93.3% of the control group. Statistically, this difference wasn’t meaningful (P = 0.59). We also found no strong links between success and gender or age. Conclusion and Discussion: From what we observed, using nitrous oxide during this type of ear surgery didn’t make much of a difference in terms of graft success. So, it seems that N₂O can be used safely in underlay tympanoplasty without increasing the risk of failure. Even though there’s been debate around this topic, our results point toward it being a reasonable and budget-friendly option. Of course, studies with larger groups and longer follow-up will help confirm this.
Keywords: Nitrous oxide, tympanoplasty, anesthetic gas, graft success, middle
