Hearing Outcomes Following Endoscopic Type I Tympanoplasty in Elderly Patients with Chronic Otitis Media

Background: Chronic suppurative otitis media (COM)can lead to tympanic membrane perforation and persistent hearing loss. The introduction of transcanal endoscopic ear surgery has improved visualization and reduced surgical morbidity, allowing for minimally invasive tympanoplasty procedures. However, age-related auditory decline and comorbidities may influence postoperative hearing outcomes. Aim: To evaluate the hearing results of endoscopic type I tympanoplasty in elderly patients (>50 years) with Chronic suppurative otitis media (COM). Methods: A prospective study was conducted on 20 patients (>50 years) undergoing endoscopic type I tympanoplasty using tragal cartilage-perichondrium graftat Minia University Hospital. Preoperative and postoperative air conduction (AC), bone conduction (BC), and air–bone gap (ABG) thresholds were measured and statistically analyzed. Results: Significant postoperative improvement in AC and ABG (p < 0.001). Anatomical graft uptake exceeded 85% of patients, while functional success (post-op ABG ≤ 20 dB or AC gain ≥ 10 dB) was achieved in 75% of patients (p = 0.05). Conclusion: Endoscopic type I tympanoplasty yields favorable anatomical and functional hearing outcomes in elderly patients. Although residual hearing thresholds remain higher among the elderly, the overall improvement and graft success rate supporting the efficacy of the endoscopic approach across age groups.