Abstract
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 air-bone 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.
Similar content being viewed by others
References
Matsuda Y, Kurita T, Ueda Y, Ito S, Nakashima T (2009) Effect of tympanic membrane perforation on middle-ear sound transmission. J Laryngol Otol 123(Suppl. S31):81–89
Athanasiadis-Sismanis A (2010) Tympanoplasty: tympanic membrane repair. In: Gulya AJ, Minor LB, Poe DS (eds) Glasscock-Shambaugh surgery of the ear, 6th edn. Peoples Medical Publishing House, Shelton, pp 465–488
Athanasiadis-Sismanis A (2010) Ossicular Chain Reconstruction. In: Gulya AJ, Minor LB, Poe DS (eds) Glasscock-Shambaugh surgery of the ear, 6th edn. Peoples Medical Publishing House, Shelton, pp 489–500
Glasscock ME III (1973) Tympanic membrane grafting with fascia: overlay vs. undersurface technique. Laryngoscope 83:754–770
Packer P, Mackendrick A, Solar M (1982) What’s best in myringoplasty: underlay or overlay, dura or fascia. J Laryngol Otol 96:25–41
Rizer FM (1997) Overlay versus underlay tympanoplasty. Part 1: historical review of the literature. Laryngoscope 107:1–23
Kartush JM, Michaelides EM, Becvarovskiz Z et al (2002) Over–under tympanoplasty. Laryngoscope 112:802–807
Sengupta A, Basak B, Ghosh D, Basu D, Adhikari D, Maity K (2012) A study on outcome of underlay overlay and combined techniques of myringoplasty. Indian J Otolaryngol Head Neck Surg 64(1):63–66
Umar AS, Ahmed Z (2008) Anatomical and functional outcome following type 1 tympanoplasty in chronic tubotympanic suppurative otitis media. Pak Armed Forces Med J 1:1–5
Mokhtarinejad F, Okhovat S, Barzegar F (2012) Surgical and hearing results of the circumferential subannular grafting technique in tympanoplasty: a randomized clinical study. Am J Otolaryngol 33:75–79
Lima JCBD, Marone SAM, Martucci O, Goncalez F, Silva Neto JJD, Ramos ACM (2011) Evaluation of the organic and functional results of tympanoplasties through a retro-auricular approach at a medical residency unit. Braz J Otorhinolaryngol 77(2):229–236
Sergi B, Galli J, De Corso E, Parrilla C, Paludetti G (2011) Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function. Acta Otorhinolaryngol Ital 31(6):366–371
Lee P, Kelly G, Mills RP (2002) Myringoplasty: does the size of the perforation matter? Clin Otolaryngol Allied Sci 27:331–334
Mehta K, Sinha V, Chhaya V, Barot D, Patel P, Patil S, Parmar V, Prashant C, Maniyar H (2009) Audiometric and operative results in type I tympanoplasty. World Article EAR, NOSE, THROAT www.waent.org.oct. Vol 2–2
Singh BJ, Sengupta A, Das S, Ghosh D, Basak B (2009) A comparative study of different graft materials used in myringoplasty. Indian J Otolaryngol Head Neck Surg 61:131–134
Karela M, Sandeep B, Watkins A, Phillips J (2008) Myringoplasty: surgical outcomes and hearing improvement: is it worth performing to improve hearing? Eur Arch Otorhinolaryngol 265:1039–1042
Mishra P, Sonkhya N, Mathur N (2007) Prospective study of 100 cases of underlay tympanoplasty with superiorly based circumferential flap for subtotal perforations. Indian J otolaryngol Head Neck Surg 59:225–228
Singh M, Rai A, Bandyopadhyay S, Gupta SC (2003) Comparative study of underlay and overlay techniques of myringoplasty in large and subtotal perforations of the tympanic membrane. J Laryngol Otol 117(6):444–448
Stage J, Bak-Pedersen K (1992) Underlay tympanoplasty with the graft lateral to the malleus handle. Clin Otolaryngol Allied Sci 17(1):6–9
Glasscock ME III (1973) Tympanic membrane grafting with fascia: overlay vs. undersurface technique. Laryngoscope 83:754–770
Guo M, Huang Y, Wang J (1999) Report of myringoplasty with interlay method in 53 ears perforation of tympani. Lin Chuang Er Bi Yan Hou Ke Za Zhi J Clin Otorhinolaryngol 13(4):147–149
Komune S, Wakizono S, Hisashi K, Uemura T (1992) Interlay method for myringoplasty. Auriss Nasus Larynx 19(1):17–22
Yadav S, Aggarwal N, Julaha M, Goel A (2009) Endoscopic assisted myringoplasty. Singap Med J 50(5):510–512
Saha Ashok K, Munshi DM, Ghosh SN (2006) Evaluation of improvement of hearing in type 1 tympanoplasty and its influencing factors. Indian J Otolaryngol Head Neck Surg 58(3):253–257
Fouad T, Rifaat M, Buhaibeh Q (2010) Utilization of amniotic membrane for graft repair of the tympanic membrane perforation. Egypt J Ear Nose Throat Allied Sci 11:97–101
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Patil, B.C., Misale, P.R., Mane, R.S. et al. Outcome of Interlay Grafting in Type 1 Tympanoplasty for Large Central Perforation. Indian J Otolaryngol Head Neck Surg 66, 418–424 (2014). https://doi.org/10.1007/s12070-014-0741-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-014-0741-3