What's best in myringoplasty: underlay or overlay, dura or fascia?

Packer, Peter; MacKendrick, Alastair; Solar, Manuel Del

doi:10.1017/s0022215100092203

Cited by 48 publications

(41 citation statements)

References 9 publications

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“…Myringoplasty using TFG and underlay technique had hearing improvement in 70-80 % of patients at the end of 1 year follow up [9,17]. In a study by Packer et al [17] reported average AB gap closure was 11.8 dB. In our study average AB gap closure was 16.09 dB.…”

Section: Hearing Improvementsupporting

confidence: 48%

“…In a study by Adkins and White [14] 25 % adult myringoplasty failures and 75 % of failures in children were observed in cases with bilaterally discharging ears. But according to the study by Packer et al [17] where overall result of myringoplasty success was close to 90 %, the success rate with bilateral chronic otitis media cases was 87 %; the difference was not statically significant.…”

Section: Graft Successmentioning

confidence: 92%

“…Since overlay technique is associated with various complications like blunting of anterior meatal angle, lateral migration of the graft, epithelial pearls and graft cholesteatoma, underlay technique is routinely followed in our hospital. Regarding hearing results, both the methods carry equally good results [9,10,17].…”

Section: Technique Of Myringoplastymentioning

confidence: 99%

“…According to Wasson et al [15], the collective myringoplasty success rate was 80.8 percent and for successful patients, the mean air conduction audiometric gain was 6.8 dB. Myringoplasty using TFG and underlay technique had hearing improvement in 70-80 % of patients at the end of 1 year follow up [9,17]. In a study by Packer et al [17] reported average AB gap closure was 11.8 dB.…”

Section: Hearing Improvementmentioning

confidence: 99%

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A Comparative Study of Temporalis Fascia Graft and Vein Graft in Myringoplasty

Parida

Nochikattil

Gopalakrishnan

et al. 2012

Indian J Otolaryngol Head Neck Surg

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To compare the surgical outcome of temporalis fascia graft (TFG) and vein graft (VG) in myringoplasty. This prospective study was carried out over 60 patients with inactive tubotympanic type of chronic suppurative otitis media, with small to moderate size central perforation in Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry from November 2009 to March 2011. Patients were equally randomized into two groups; TFG group and VG group according to the graft material used for myringoplasty. After routine investigations, X-ray mastoid and paranasal sinuses and pure tone audiometry, all cases were operated under local anesthesia using underlay technique. Patients were followed at 2 week, 1 and 3 month postoperatively. Graft uptake, audiological improvement, degree of hearing improvement, and complications were studied during follow up. In TFG group, graft uptake rate was 80 % and hearing improvement was present in 66.7 % whereas in VG group graft uptake rate was 83.3 % and hearing improvement was present in 70 %. No patient had deterioration in hearing, sensory neural hearing loss or any other complications postoperatively. Difference between the preoperative and postoperative air bone (AB) gap was considered as degree of hearing improvement. Postoperative AB gap was \10 dB in 60 % and 66.7 % of patients of TFG group and VG group respectively. The difference in graft uptake rate and hearing improvement between two groups was not statistically significant. Both TFG and VG are equally effective in terms of graft uptake and hearing improvement in myringoplasty.

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Section: Hearing Improvementsupporting

confidence: 48%

Section: Graft Successmentioning

confidence: 92%

Section: Technique Of Myringoplastymentioning

confidence: 99%

Section: Hearing Improvementmentioning

confidence: 99%

See 2 more Smart Citations

A Comparative Study of Temporalis Fascia Graft and Vein Graft in Myringoplasty

Parida

Nochikattil

Gopalakrishnan

et al. 2012

Indian J Otolaryngol Head Neck Surg

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“…(Fig. 1) In overlay technique there are chances of anterior canal wall blunting, lateralisation of the graft, formation of epithelial pearls, excessive membrane thickness, and longer duration of healing and increased risk of iatrogenic cholesteatoma [4][5][6]. The disadvantages of underlay technique are that the middle ear space is reduced, there are chances of medialisation of the graft [6], less suitable for large anterior perforations [7] and longer healing time.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Interlay Grafting in Type 1 Tympanoplasty for Large Central Perforation

Patil

Misale

Mane

et al. 2014

Indian J Otolaryngol Head Neck Surg

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A prospective, cohort, clinical study was conducted at Dr. D. Y. Patil Hospital, Kolhapur from August 2010 to August 2013. The aim was to evaluate the results of type 1 interlay tympanoplasty with respect to graft uptake, hearing improvement and complications. Total of 100 cases with a mucosal type of chronic suppurative otitis media and a large central perforation (involving more than 50 % of tympanic membrane) were operated for type 1 tympanoplasty where the graft was placed by interlay method (below the fibro-squamous layer and above the mucosal or endothelial layer). Patients were followed up with ear microscopy at each follow up visit and an audiometry at the end of 3rd month. Statistical analysis was done by statcal software using paired t test and two sample t test for proportion. 96 (96 %) cases had a successful graft uptake. The mean pre-operative air-bone gap was 36.42 ± 12.0 dB; whereas the mean post-operative airbone gap was 9.7 ± 6.71 dB. Except for residual perforation in four patients and partial tympanomeatal flap necrosis in two patients no other complications were encountered. Thus, we conclude that, the interlay tympanoplasty is a safe and effective method of graft placement for large central perforation.

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Implantate in der Mittelohrchirurgie

1992

Teil I: Referate

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What's best in myringoplasty: underlay or overlay, dura or fascia?

Cited by 48 publications

References 9 publications

A Comparative Study of Temporalis Fascia Graft and Vein Graft in Myringoplasty

A Comparative Study of Temporalis Fascia Graft and Vein Graft in Myringoplasty

Outcome of Interlay Grafting in Type 1 Tympanoplasty for Large Central Perforation

Implantate in der Mittelohrchirurgie

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