DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20205631

Outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforation: a retrospective comparative study

Rajneesh ., Dinesh Valse, Shradha Pawar, Anil Kumar Doddamani

Abstract


Background: Aim and objective were to study the outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforations in terms of graft uptake rate and hearing improvement.  

Methods: The present study was conducted retrospectively on 110 patients of inactive mucosal chronic otitis media with large central perforation, 55 patients selected from each group undergoing underlay or interlay technique in a tertiary referral hospital, Department of ENT, ESIC Kalaburagi, Karnataka, from February 1 2018 to January 31, 2020.  

Results: Total 110 patients were included in the study. Male:female ratio was 1:2.2. The age group in this study ranged from 13-50 years of age. Preoperative mean air bone gap in groups A and B was 30.28±6.62, and 30.18±6.87 dB and postoperative mean air bone gap was 19.44±7.66 and 15.13±6.3 dB. In both the groups a significant mean reduction in air bone gap was observed. Mean reduction was maximum in group B. Statistically, intergroup difference in reduction in air bone gap was highly significant (p<0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.

Conclusions: Interlay is a better technique than underlay in chronic otitis media inactive mucosal disease with large central perforation in terms of hearing improvement and graft uptake.  


Keywords


Tympanoplasty, Underlay, Interlay, COM

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References


Berthold E. Ueber myringoplastik. Wier Med Bull 1878;1:627

Frootko NJ. Reconstruction of the ear. In: Kerr AG, Booth JB, editors. Scott Brown’s Otolaryngology: Otology. 6th ed. Oxford: Butterworths-Heinnman. 1997;3:1-25.

Rafi T. Tympanoplasty in children: A study of 30 cases. J Surg Pak. 2001;6:11-2.

Manolidis S. Closure of tympanic membrane perforations. In: Glasscock ME, Gulya AJ, editors. Glasscock Shambaugh Surgery of the Ear. 5th ed. Ontario: BC Decker. 2003;19:400.

Dornhoffer J. Cartilage Tympanoplasty: Indications, techniques and outcomes in 1000 patient series. Laryngoscope 2003;113:1844-56.

Murbe D. Zahnert T, Bornitz M, Huttenbrink KB, Acoustic properties of different cartilage reconstruction techniques of the tympanic membrane. Laryngoscope. 2002;112:1769-76.

Sheehy JL, Crabtree JA. Tympanoplasty: Staging the operation, Laryngoscope. 1973;83:1594-621.

Shea JJ. Vein graft closure of eardrum perforation. J Laryngol Otol. 1960;74:358-62.

House WF. Myringoplasty. Arch Otolaryngol. 1960;71:399-404.

Eavey RD. Inlay tympanoplasty: cartilage butterfly technique. Laryngoscope. 1998;108:657-61.

Komune S, Wakizono S, Hisashi K, Uemura T. Interlay method for myringoplasty. Aur Nas Larynx. 1992;19(1):17-22.

Karlan MS. Gelatin film sandwich in tympanoplasty. Otolaryngol Head Neck Surg. 1979;87:84-6.

Schwaber MK. Postauricular undersurface tympanic membrane grafting: some modifications of the ‘swinging door’ technique. Otolaryngol Head Neck Surg. 1986;95:182-7.

Fernandes SV. Composite chondroperichondrial clip tympanoplasty: the triple “C” technique. Otolaryngol Head Neck Surg. 2003;128:2:267-72.

Juvekar MR, Jurekar RV. The double breasting technique of tympanoplasty: a study of 200 cases. Indian Journal of Otology. 1999;5:3:145-8.

Hung T, Knight JR, Sankar V. Anteriosuperior anchoring myringoplasty technique for anterior and subtotal perforations. Clin Otolaryngol. 2004;29;3:210-4.

Eocudero LH, Castro AO, Durmond M. Argon Laser in human tympanoplasty. Arch Otolaryngol 1979;105:252-3.

Goodman WS, Wallace IR. Tympanoplasty – 25 years later. J Otolaryngol. 1980;9:155-64.

Gersdorff M, Gérard JM, Thill MP. Overlay versus underlay tympanoplasty. Comparative study of 122 cases. Rev Laryngol Otol Rhinol (Bord). 2003;124:15-22.

Sergi B, Galli J, De Corso E, Parrilla C, Paludetti G. Overlay versus underlay myringoplasty: Report of outcomes considering closure of perforation and hearing function. Acta Otorhinolaryngol Ital. 2011;31:366-71.

Guo M, Huang Y, Wang J. Report of myringoplasty with interlay method in 53 ears perforation of tympani. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 1999;13(4):147-9.

Vishal US. A one-year prospective study to evaluate the results of superiorly based tympanomeatal flap in endoscopic myringoplasty conducted in District Hospital, Belgaum and KLES and MRC, Belgaum during July 2003 to July 2004. Dissertation, MS (ENT), RGUHS, Karnataka. 2006

Hay A, Blanshard J. The anterior interlay myringoplasty: outcome and hearing results in anterior and subtotal tympanic membrane perforations. Otol Neurotol. 2014;35(9):1569-76.

World Health Organization. Chronic suppurative otitis media, burden of illness and management options. Geneva: WHO Child and Adolescent Health Department, Prevention of Blindness and Deafness; 2004.

Kawatra R, Maheshwari P, Kumar G. A comparative study of the techniques of myringoplasty – overlay, underlay & interlay. J Dent MED Sci. 2014;13:12-6.

Jain S, Gupta N, Gupta R, Roy A. Interlay type 1 tympanoplasy in large central perforations: Analysis of 500 cases. Ind J Ophthalmol. 2017;23:32-5.

Komune S, Wakizono S, Hisashi K, Uemura T, Interlay Method For Myringoplasty. Larynx Auris Nasus. 1992;19(1):17-22.

Patil BC, Misale PR, Mane RS, Mohite AA. Outcome of interlay grafting in type 1 tympanoplasty for large central perforation. Ind J Otolaryngol Head Neck Surg. 2014;66:418-24.