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VOLUME 10 , ISSUE 3 ( September-December, 2018 ) > List of Articles

RESEARCH ARTICLE

To Evaluate and Compare the Results of Over-underlay Graft Technique with Conventional Underlay Myringoplasty

Keywords : Myringoplasty, Over-underlay, Underlay,Chronic suppurative otitis media

Citation Information : To Evaluate and Compare the Results of Over-underlay Graft Technique with Conventional Underlay Myringoplasty. Int J Otorhinolaryngol Clin 2018; 10 (3):94-98.

DOI: 10.5005/jp-journals-10003-1301

License: CC BY-NC 4.0

Published Online: 00-12-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: To evaluate the efficacy of over-underlay graft technique of myringoplasty and compare the results of over-underlay graft technique with conventional underlay myringoplasty. Materials and methods: In this prospective study 40 patients of either sex in age group of 15–50 years with noncholesteatomatous chronic suppurative otitis media (CSOM) were recruited. Patients were initially managed medically to make the ear dry and after that they were operated upon. Twenty patients underwent conventional underlay myringoplasty and 20 patients underwent over-underlay myringoplasty. Follow-up period was at least 3 months. Results: Graft uptake and hearing improvement was comparable in both groups. Although there was 5% lower graft uptake in group underwent conventional underlay myringoplasty (90%) as compared to over-underlay myringoplasty (95%); however, the difference was not statistically significant (P = 0.5). But there was statistically significant difference in gain in hearing threshold (gain in A–B gap) in the conventional underlay myringoplasty (14.5 dB ± 7.236) as compare to over-underlay myringoplasty (18.75 dB ± 5.349 ) (p = 0.04). Conclusion: The over-underlay technique, which is hybrid of both overlay and underlay technique, allows the advantages of both methods. It improves graft uptake rate and hearing improvement in subtotal and large perforations.


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  1. Gopen Q. Pathology and clinical course of inflammatory disease of the middle ear. In: Gulya AJ, Minor LB, Poe DS. editors. Glasscock – Shambaugh Surgery of the ear 6th ed. Shelton: Peoples Medical Publishing House-USA, 2010, p. 425–436.
  2. Maroto PD, Gutierrez JJE, Jimenez MC, Morente JCC, Rodrnguez VP, Benitez-Parejo N. Functional results in myringoplasties. Acta Otorrinolaringol Esp. 2010; 61 : 94–96.
  3. Packer P, Mackendrick A, Solar M. Whats best in myringoplasty: underlay or overlay, dura or fascia? J Laryngol Otol 1982;96:25–41.
  4. Weider DJ. Use of William's microclips in various aspect of tympanoplastic surgery. Laryngoscope 1981;91:2106–2125.
  5. Forrior JB. Sandwich graft tympanoplasty: experience, results and complications. Laryngoscope 1989;99:213–217.
  6. Lee YP, Auo HJ, Kang JM. Loop overlay tympanoplasty for anterior or subtotal perforations. Auris Nasus Larynx 2010; 37:162–166.
  7. Kartush JM, Elias M, Michaelides EM, Becvarovski Z, La Rouere MJ. Over-underlay myringoplasty. Laryngoscope 2002;112:802–807
  8. Lerut B, Pfammatter A, Moons J, Linder T. Functional correlations of tympanic membrane perforation size. Otol Neurotol 2012; 33: 379–386.
  9. Schuknecht HF. Myringoplasty. Clin Otolaryngol 1976;2: 53–65.
  10. Stage J, Bak-pederson K. Underlay tympanoplasty with the graft lateral to the malleus handle. Otolaryngol Clin North Am 1992;17:6–9
  11. Ahmed Z, Aslam MA, Aslam MJ, Sharif A. Ahmed MI. Over-under myringoplasty. J Coll Phys Surg Pak 2005; 15: 768–770.
  12. Yigit O, Alkan S, Topuz E, Uslu B, Unsal O, Dadas B. Short term evaluation of over-underlay myringoplasty technique. Eur Arch Otorhinolaryngol 2005;262:400–403.
  13. Aslam MA, Aslam MJ. Comparison Of Over-Underlay And Underlay Techniques Of Myringoplasty. Pak. Armed Forces Med. J,2009:3.
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