Influence of menstrual cycle phase and serum oestrogen levels on tympanoplasty outcomes in women

Abstract Objective To evaluate whether menstrual cycle phase and serum oestrogen influence tympanoplasty outcomes in premenopausal women. Methods Eighty women with small central tympanic membrane perforations (follicular phase, days 1–5, n = 40; ovulatory phase, days 12–16, n = 40) underwent endoscopic transcanal type I tympanoplasty. Outcomes were anatomical success (at 12 weeks) and hearing improvement. Pre-operative serum oestrogen and its predictive value were assessed. Results Graft success was higher in the ovulatory than follicular phase (90 vs 70 per cent, p = 0.025). Hearing gain was greater in the ovulatory phase (12.35 ± 4.84 dB vs 4.70 ± 3.92 dB, p < 0.001). Serum oestrogen was significantly higher in the ovulatory phase. Receiver operating characteristic analysis showed modest predictive performance (area under the curve = 0.643). Conclusion Tympanoplasty during the ovulatory phase is associated with improved anatomical and functional outcomes, suggesting that endogenous oestrogen benefits tympanic membrane healing.